Pestle finger, also known as drumstick finger, occurs at the end of the finger and is characterized by widening and thickening of the finger, protruding nails, and a pestle-like shape of the entire finger. Pestle finger may be due to lack of oxygen in the end tissues of the fingers, causing compensatory capillary hyperplasia, soft tissue hypertrophy, connective tissue hyperplasia, the formation of pestle finger is mostly related to hypoxia. Common causes include the following: 1, cyanotic congenital heart disease: such as tetralogy of Fallot, complete pulmonary vein ectopic drainage, tricuspid atresia, etc.; 2, respiratory system diseases: the most common are chronic lung diseases and lung tumors, such as idiopathic pulmonary fibrosis, tuberculosis, emphysema, abscess chest, bronchiectasis, etc. The long-term existence of these diseases can lead to intrapulmonary shunts, which can also cause pestle fingers; 3. Digestive system diseases: such as Crohn’s disease, chronic ulcerative colitis, intestinal tuberculosis, amebic dysentery, etc., can also lead to pestle finger; 4. Others: idiopathic osteoarthrosis and certain poisonings, such as arsenic poisoning, alcoholism, etc., can also be seen in nutritional disorders. In short, pestle finger is related to hypoxia, the cause should be clarified and treated for the cause.