Carpal tunnel syndrome is a “cumulative trauma disorder” that results from chronic and repetitive overuse of the hands and frequent wrist flexion. This discomfort can sometimes be relieved to some extent by changing the posture of the upper extremity or by shaking the hand. As the condition worsens, patients may develop atrophy of the outermost muscles of the greater pisiformis, inflexibility of the thumb, decreased strength to pinch with other fingers or even inability to complete the pinching motion. Carpal tunnel syndrome is the most common form of peripheral nerve entrapment, accounting for the highest incidence of peripheral nerve entrapment in clinical practice. The traditional carpal tunnel incision for median nerve release requires a long “S” shaped incision between the middle of the palm and the distal forearm. This incision provides good exposure of the carpal tunnel and median nerve, but is prone to persistent postoperative hand weakness, scar indentation at the incision site, and pain between the pisiformis. In order to reduce the complications after traditional carpal tunnel dissection and median nerve release, a small incision under local anesthesia for carpal tunnel syndrome can provide adequate exposure and a small incision, allowing complete dissection of the carpal tunnel and exploration of the median nerve.