Background: Stenosing tenosynovitis is a common cause of painful hand dysfunction. Occupational therapists frequently manage these patients’ using orthoses, exercises, and other conservative modalities, but the overall effectiveness of these strategies remains unclear, especially in settings such as Saudi Arabia. We aimed to systematically review the evidence on occupational therapy related interventions for trigger finger, focusing on functional outcomes and implications for practice. Methods: A systematic search of major electronic databases identified clinical studies evaluating non-surgical, rehabilitation-oriented interventions for adult trigger finger. Ten original studies on splinting, hand therapy modalities, guided injections, and exercise-based programmes were included, alongside ten review and guideline papers used to contextualise the findings. Data were extracted on design, sample, interventions, and patient centred outcomes. Results: Orthotic management and structured conservative protocols consistently reduced pain and triggering and improved hand function. Radial extracorporeal shockwave therapy and tendon, hand exercise programmes produced clinically important improvements, while ultrasound guided steroid injection optimised accuracy with similar short-term outcomes to blind techniques. However, evidence specific to occupational therapy, return to work, and role performance remains limited, and no included study was conducted in Saudi Arabia. Conclusion: Conservative, hand therapy-oriented management of trigger finger is effective for many patients and aligns well with occupational therapy practice. High quality, context specific research from Saudi Arabia is needed to guide local service development.