Objective To compare outcomes of patients undergoing either open or endoscopic carpal tunnel release for the treatment of idiopathic carpal tunnel syndrome. Methods A prospective

randomized study was performed on 70 hands in 62 patients with idiopathic carpal tunnel syndrome from April 2000 to April 2004. Either open （36 hands in 30 patients） or endoscopic （34 hands in 32 patients） carpal tunnel release was performed randomly. Symptom improvement

complications

and the time of operation

in-hospital stay

and return to work between the two groups were assessed with average 2 years of follow-up. The electromyography was tested pre- and 3 months post-operation. Results There were no significant differences between the two surgical groups with regard to postoperative improvements of symptom

electromyography tests

and the incidence of complications. But it was statistically less in the rate of scar tenderness

the time of operation

in-hospital stay

and return to work in the endoscopic group compared with the open group （P<0.05）. Conclusions The endoscopic carpal tunnel release is a reliable method in the treatment of idiopathic carpal tunnel syndrome. And it has the advantages of slight scar tenderness

less operation time

less in-hospital stay

early functional recovery

safety

and high satisfaction rate compared with open methods.