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Abstract Background: Stroke survivors have difficulties in task performance because of motor paresis. Triggered electrical stimulation is reported to be more effective than non-triggered electrical stimulation in facilitating upper extremity motor recovery. Objective: The purpose of this study was to compare between electromyogram- triggered stimulation versus alternating electromyogram stimulation on hand functions in chronic stroke patients. Subjects and Methods: Forty five chronic stroke patients of both sexes participated in the study. They were randomly divided into 3 equal groups (A, B and C). Each group received the same designed physical therapy program for hand function training in addition to electromyogram-triggered stimulation for group A and alternating electromyogram stimulation for group B. Peak muscle torque was assessed by electromyography (EMG) threshold, hand dexterity was assessed by box and block test, upper limb function was assessed by Action Research Arm test, and quality of life was assessed by Short-Form 36-Item Health Survey (SF-36®). Measurements were taken before and after two months of intervention protocol for every patient in each group. Results: Data analysis revealed significant improvement in peak muscle torque, hand dexterity, upper limb function, and quality of life within each group post-treatment,with greater improvement percentages in group (B). There were significant differences between the alternating electromyogram stimulation group (group B) and electromyogram- triggered group (group A) compared to the control group in all measured parameters post treatment except for the quality of life scale scores |