Aim: The purpose of this study is to compare the effect of epineurotomy of median nerve with just division of the transverse carpal ligament in the treatment of carpal tunnel syndrome. Patients & Methods: We conducted a prospective, random study to evaluate the effect of epineurotomy on the outcome of operative treatment of established median-nerve compression in the carpal canal. Fifty hands (forty-four patients) were selected randomly into two groups: group I had a release of the transverse carpal ligament alone, and group II had a release and adjuvant epineurotomy of the median nerve. The groups were similar with regard to age group, gender, duration of symptoms, and preoperative physical findings. All patients had electrophysiological evidence of sensory delays and fibrillations on preoperative testing. Results: The patients were evaluated perioperatively and postoperatively after 6 months. The results show (60%) in group I and (56%) in group II who no longer had any symptoms referable to the dysfunction of the median nerve. On physical examination, the average two-point discrimination was 5.1 mm in group I, and 4.7 mm in group II. The electrophysiological tests revealed an average sensory latency 4.1 msec in both groups. The follow-up examination revealed no detectable differences between the two groups with regard to symptoms, objective findings, or electrophysiological findings. Conclusions: we conclude that the epineurotomy of the median nerve offers no benefit compared with sectioning of the transverse carpal ligament alone.