Replantation of a two level amputated fingertip is a very controversial and challenging procedure.In children, this procedure can seem impossible[1,2] .Here, we report a case of a two level amputated fingertip with successful microsurgical replantation and non-microsurgical reattachment. A 3-year-old boy had his distal phalanx of the right index finger amputated at two levels by a hay cutter and was referred to our centre 6 hours after injury.The proximal amputation occurred at the distal interphalangeal joint, and the distal amputation occurred at the distal third of the nail bed.The distally amputated portion contained a small distal part of the distal phalanx.The wounds were clean-cut and slightly contaminated. The surgical procedure was performed under general anaesthesia, and a finger tourniquet was utilised.Two amputated portions were prepared under the operating microscope.Within the proximal portion, the ulnar digital artery, a lateral vein and a dorsal vein were identified and tagged.Within the distal portion, no artery or vein was suitable for anastomosis.Hence, we decided to replant the proximal amputated portion and reattach the distal amputated portion to the proximal portion.The two amputated portions were fixed to the stump with an axial K-wire.