Background: Carpal tunnel syndrome (CTS) is the most prevalent upper-limb entrapped neuropathy. A nerve conduction study (NCS) is the simplest method for identifying CTS when combined with a satisfactory clinical assessment and physical assessment. Ultrasound is a beneficial non-traumatic screening approach for CTS and there is a relationship between the NCS tests and the measures of CSA by ultrasound. Objective: to assess whether or not sonographic observations of the median nerve seems to be varied amongst DM and non-DM CTS individual. Patients and methods: The total of 50 non-DM Individuals with CTS and 50 DM individuals with CTS have been included in this study. All individuals were submitted to full medical assessment NCS testing the hands and sonogram US for assessment of cross-sectional area CSA and wrist forearm ratio (WFR). Results: Total 100 affected wrists with CTS are classified as 30 (60.0%) wrists with mild disease, 11 (22.0%) wrists that demonstrated moderate disease and 9 (18.0%) wrists had a severe disease in diabetic CTS patients and 23 (46.0%) wrist mild disease, 20 (40.0%)wrist show moderate disease, 7 (14.0%) wrist had a severe disease in non-diabetic CTS patient. The mean of the median nerve CSA was (0.14+0.03), (0.15+0.04) in diabetic and non-diabetic CTS individuals, respectively with no significant difference between the two groups. In contrast, the wrist-forearm ratio demonstrates a significant difference between the two groups. Conclusion: The CSA of the median nerve is greater in CTS wrists through both DM and non-DM individuals with no significant difference. The mean wrist-forearm ratio was less in diabetic patients than in non-diabetic with a significant difference. Pairing NCS with US imaging gives effective assessment methods for the CTS hands in individuals with and without diabetes.