Median nerve compression in hand at the level of transverse ligament leads to numbness and pain in the hands, which results in discomfort in daily routine work has a psychological impact. The objective of the present study was to evaluate the modified mini-incision at the transverse crease in carpal tunnel syndrome. Methodology: A prospective descriptive study was conducted at Neurospinal & cancer care Institute, Karachi, from January 2012 – February 2020. Patients who were diagnosed with

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... al symptoms, positive Phalen and Tinel test and confirmed with EMG finding of carpal tunnel syndrome were included in the study. Patients were operated through modified mini-incision at the transverse crease. The outcome was recorded in the form of pain relief, healing time with restoration of daily life activity and scar adhesion on follow-up. Results: A total of 97 patients were included. The male to female ratio was 1:7.8. The mean age was 40 ± 19.5 years. The right hand was 72.2%, the left hand was 13.4%, and the bilateral was 14.4%. VAS score improved 2 grades in 96%, and pinch grip improved in 98% of patients in one month. Only 2% of patients had stiffness after surgery Conclusion: Minimal incision carpal tunnel release has shown positive outcome in median nerve compression, having limited skin incision, safe, feasible and minimizing the scar assist help in early return to work.