Abstract: Background: Split-thickness skin grafting (STSG) is a cornerstone in reconstructive surgery. The Humby knife and shaving blade are two techniques for harvesting grafts, but their comparative efficacy remains understudied. This trial evaluates outcomes of both methods in 100 patients. Methods: A single-center RCT (2021–2023) 100 patients dividing 2 groups, having procedure of Humby knife (n=50) and shaving blade (n=50). Primary outcomes included graft take rate and complications; secondary outcomes were operative time, pain scores, and cosmetic results. Statistical analysis used t-tests, chi-square, and multivariate regression. Results: The Humby knife group had higher graft take rates (94% vs. 82%, p=0.03), lower infection rates (4% vs. 14%, p=0.04), and superior cosmesis (Humby : 6% vs. Shaving 18% (p=0.03%). Operative time was longer for Humby (28.5 ± 4.1 vs. 18.2 ± 3.8 minutes, p<0.001). Conclusion: The Humby knife offers superior graft survival and cosmetic outcomes despite longer operative time, advocating its use in critical reconstructive cases.