Three hundred and two patients with treatment-naïve Dupuytren’s contracture were randomized to receive percutaneous needle fasciotomy (n=100), surgery (n=101), or collagenase injection (n=101). The primary outcome of interest was the success rate, defined as greater than 50% contracture release and patients reaching the patient-acceptable symptom state at both 3 months and 2 years. Secondary outcomes of interest included hand function (QuickDASH), pain, quality of life (EQ-5D-3L), patient satisfaction, residual contracture angle, finger flexion, and serious adverse events. Outcomes were assessed at 3 months and 2 years. Overall, the results of the study revealed that while short-term outcomes were comparable among all treatments, surgery demonstrated superior long-term success rates and lower risk of re-treatment. Surgery maintains higher success rates at the two-year follow-up compared to the other treatments, suggesting it is the most effective long-term intervention for Dupuytren’s contracture.