A total of 90 patients with carpal tunnel syndrome (CTS) were randomized to undergo surgical treatment using either open carpal tunnel release (OCTR) with a classic incision, OCTR with a short incision approach, or endoscopic carpal tunnel release (ECTR). The purpose of this study was to compare the efficacy of each treatment in terms of post-operative pain, and the disappearance of paraesthesia, as well as grip strength, range of motion, sick leave, and rate of associated complications. At 24 weeks, results demonstrated no significant intergroup differences in pain, paresthesia, range of motion, risk of complication, and grip strength. However, a significantly shorter sick leave for the endoscopic group and intermediate differences during follow-up, particularly in grip strength at 6-12 weeks, were observed in patients that received ECTR and OCTR with classic incision compared to OCTR with short incision.