Objective: The study investigated the resolution of triggering by either a soluble methylprednisolone acetate or dexamethasone injection for idiopathic trigger finger at 24-week after injection. Material and Methods: One hundred and six patients were enrolled in a prospective randomized controlled trial (53 methylprednisolone acetate arms, 53 dexamethasone arms). The outcome was evaluated at 2, 6, 12 and 24-week follow-up. Results: The absence of triggering was documented in 32 of 43, 36 of 41 patients in the methylprednisolone cohort and in 20 of 43, 29 of 32 patients in the dexamethasone cohort at 6 and 24-week after injection. The methylprednisolone acetate cohort had significantly better satisfaction on a visual analog scale, tenderness, and locking at 2-week follow-up, and had significantly better satisfaction on resolution of triggering, tenderness, snapping, locking and the Disabilities of the Arm, Shoulder and Hand score at 6-week follow-up compared to those in the dexamethasone cohort. Conclusion: Methylprednisolone acetate is better in short term clinical outcomes than dexamethasone