Since my last post, there have been many new trackball mouse releases, so my I'm refreshing my recommendations here. TLDR; ambidextrous trackball: Ploopy Adept; MSTE-style: Ploopy Classic 2; keyboard with trackball: Svalboard. This post contains affiliate links, but is unbiased - evidenced by lacking affiliate for those top picks.
Sometimes called "Wedge" trackballs, these can be either left or right -handed. Innovated by Kensington Expert, refined by SlimBlade Pro, and perfected by Adept. These have an unusual layout - a square, with the ball in the middle - and preferable for hover-hand over palm-rest. Hover-hand is better than resting trackballs with walking or standing desks. You can still use a wrist-rest, it's just slightly more awkward than MSTE-style. For those with serious RSI or CTS, I recommend wedges. Switch to your non-dominant hand for work; and back to your dominant hand for gaming. To switch, you'll map a button (Adept using VIA) or use a software profile (others).

Adept has durable and clicky switches. High polling rate. Dynamic steel roller bearings making stiction 0. If they rust, you can replace them. These attributes also make Adept great for gaming. It's my daily driver; my favorite ergonomic mouse of all time. Ambidextrous for gaming (right) vs productivity (left). And great for hover-hand when I'm walking. Ploopy really steals the stage. It's relatively inexpensive (eg, compared to the gap between Nulea M505 and Ploopy Classic 2). Though you do have to pay international shipping (Canada), which adds $10-20.

Nulea M512 adds some bells and whistles, but reports slightly worse stiction than SlimBlade (which is already worse than Adept, due to static bearings). Yes it's cheaper than Adept, due to international shipping costs, but I highly recommend paying extra for Adept, if this is your daily driver. That or wait for Protoarc EM06 to see how their bearings shake out.
Microsoft Trackball Explorer (MSTE) was one of the very first trackball mice, and was very beloved. Some hang onto their old ones, or buy one off eBay, swearing by its quality. So most finger trackball mice follow its design. These will usually be right-handed, rarely left-handed, and is intended for resting your palm on, possibly with a wrist rest. Think of MSTE trackballs as "standard". The few non-MSTE-style, non-Wedge-style, mice are X-Keys L-Trac and GameBall.

Once there was Ploopy Classic 1, perfect in every way except one fatal flaw: 8mhz scroll-wheel polling, making scrolling near impossible. Well they just released Classic 2, which (1) fixes the scrolling totally; (2) adds USB-C. Since scrolling was its only issue, besides which it was the best MSTE trackball out there, this finally puts it as the best MSTE. It's highly ergonomic, with dynamic steel ball bearings, and very high polling rates. Great for precision and gaming.

Nulea M505 followed suite with a budget offering. There are complaints of stiction, so be mindful; but if you're tight on cash, it's a great option.

If your RSI / carpal tunnel is medical-grade - or if you're just stinking rich - get this. It's a keyboard with an integrated trackball. The ball is positioned just so to minimize reach. And the key motions are significantly minimized compared to even the best ergonomic keyboards. It's the most ergonomic mouse, and most ergonomic keyboard that you can possibly buy. It has a significant learning curve, requiring re-training your brain, and a lot of cash.
There's GameBall and X-Keys L-Trac. L-Trac has dynamic bearings, which is a rare treat, but it's just so old and clunky - there's no reason not to get Ploopy instead. And GameBall, I found, was not nearly as ergonomic as a Wedge (since they're targeting ambidextrous); nor a MSTE (since it's a resting mouse). Further, it has static bearings. Damn good ceramic bearings, and stiction is low; but dynamic bearings are superior. However! Keep an eye for GameBall Pro, launching sometime 2025 - that might give Ploopy a run for their money.
I'm notably missing the popular Elecom Huge and Elecom Deft Pro. The reason being they're infamous for stiction, requiring mouse surgery to replace poor stock bearings. If you're up to the task (find a bearings-replacement video), these can be great mice. But IMO, Classic 2 has everything you need.
I'm also missing thumb-ball and vertical mice. See my prior post on why to skip vertical mice entirely; and why finger-balls are better than thumb-balls. But if you can't be convinced, then the best thumb-ball options:

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