A series of 22 patients with carpal tunnel syndrome secondary to chronic tenosynovitis was divided into two groups. The first group was treated by transverse carpal ligament release alone. The second group was treated by transverse carpal ligament release, external neurolysis of the median nerve, flexor synovectomy, and intraoperative corticosteroid instillation. Both groups were comparable preoperatively as to symptoms, signs, and electrophysiological data. At two years postoperatively there were no statistically significant differences in the symptoms, signs, and electrophysiological data in the two groups. The only difference was that patients undergoing release alone were able to return to work earlier than those patients who had the adjunctive procedures.