A 32-year-old man sustained a fireworks-related blast injury to his left hand. He underwent revision amputation during the acute phase of injury. The procedure included a revision left thumb amputation through the metacarpophalangeal joint and index, long, and ring finger ray amputations. The length of his little finger was retained. In preparation for thumb reconstruction, the patient underwent a groin flap to his left hand. This video demonstrates left thumb reconstruction via a second toe transfer with microvascular anastomosis.