Dupuytren disease (DD) is a hyperproliferative disorder that can lead to digit contractures and significant functional sequelae. Treatment for DD aims to control the disease symptoms but cannot cure the disease, and recurrence is common. With the many options for percutaneous, enzymatic, and open treatment for DD, it is helpful to have guidance on the treatment and outcomes of primary and recurrent disease. There is no single best treatment option and decisions should be made on an individual basis with the patient’s specific contracture, current anatomy, neurovascular status, goals, and postoperative recovery in mind. When deciding on primary treatment, some literature supports needle aponeurotomy over limited fasciectomy as a primary treatment modality as there is an improvement in contracture reduction if needle treatment is performed as the primary treatment followed by limited fasciectomy for recurrent treatment. It has also been found that needle aponeurotomy may delay the need for open fasciectomy by 2.9 years on average [1]. When considering treatment options for recurrent disease, percutaneous or enzymatic techniques may be considered in the setting of a well-defined cord. Percutaneous and enzymatic treatments are as effective for recurrent disease as when they are used for primary disease, even in the setting of prior surgical treatment, though enzymatic techniques may carry higher complication rates in the setting of prior surgery. Open surgical techniques can be considered in all settings of recurrence, and may be superior to percutaneous or enzymatic techniques in the setting of poorly defined cords or diffuse disease. In the setting of severe contractures and diffuse disease, open techniques such as limited open fasciectomy or dermofasciectomy should be employed. Continuous passive elongation can be used as an adjunct technique such as the use of skeletal extension torque in the setting of significant PIP contracture and can also be used prior to surgical intervention to reduce contracture and potentially reduce neurovascular injury. When counseling patients on what to expect, some studies have found that while more challenging, treatment for recurrent disease may be as effective as treatment for primary disease, with some reports of increased neurovascular injury in those undergoing treatment for recurrent disease [2].