18 studies (level II evidence and below) investigating the use of open simple or endoscopic release of idiopathic cubital tunnel syndrome were included in this systematic review to compare the clinical outcome and complication rates between these procedures. The results of the study demonstrated that open simple decompression and endoscopic decompression are both effective treatments for cubical tunnel syndrome. Assessments of complications did show that hematoma occurred in more patients receiving endoscopic treatment, but these cases were mostly managed conservatively. Contrastingly, endoscopic treatment was found to reduce medial antebrachial cutaneous (MABC) nerve injury and scar sensitivity when compared to open treatment. Further research is required using randomized controlled trials before definitive conclusion can be made regarding the comparative efficacy of these treatments