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Objective: To compare efficacy of methyl prednisolone acetate injection with and without thumb spica cast for the treatment of de-Quervain tenosynovitis. Study Design: Randomized Controlled Trial. Setting: Orthopedic Unit, Allied Hospital, Faisalabad. Period: April 2016 to September 2016. Material & Methods: In each group 41 patients were included with non-probability consecutive sampling. Results: Eighty two patients were enrolled in the study. Out of 82 patients in the study, 3 (3.7%) were males and 79 (96.3%) were females. There were 10 (12.20%) pateints with age >40 years, and 36 (43.90%) patient in each of age group 21-30 and 31-40 years. The proportions of cured persons between two groups i.e., treated with corticosteroid injection and those treated with combination of injection and thumb Spica splint were found same with p-value 0.19 for Z=1.31. The efficacy was independent of treatment methods with Χ2=1.10 (p-value = 0.30). The same independence pattern was also observed in different age groups. Age range was between 18 and 70 years. Statistical analysis was performed using chi-square test. Six weeks following treatment, 29 (35.37%) patients from group A and 34 (41.46%) patients from group B showed relief of pain, swelling and tenderness and a negative Finkelstein test (p-value 0.295). post stratification of gender showed no significant association (p-value 0.388 and 0.328 in groups A and B respectively). Conclusion: It has been concluded that use of corticosteroid injection alone is sufficient to treat de-Quervain syndrome as compared to the use of thumb Spica splint with corticosteroid injection. It is therefore recommended that in patients suffering from de-Quervain syndrome, corticosteroid injection may be the choice of treatment. [ABSTRACT FROM AUTHOR]