Seventy-seven elbows from seventy-one patients with refractory lateral epicondylitis were included in this randomized controlled trial. Patients were randomized to receive either denervation (n=12) or epicondylar desinsertion (n=13), while a non-randomized group (n=52) also received desinsertion due to a negative nerve block response. The primary outcome was postoperative pain (maximal and resting) assessed using the visual analog scale. Secondary outcomes included grip strength (Jamar dynamometer), functional scores (Q-DASH and PREE), and work cessation rates. Assessments were conducted preoperatively and at 6 weeks, 3 months, 6 months, and 12 months. Overall, the results of the study revealed no statistically significant differences between denervation and desinsertion for any clinical outcome. However, both groups showed significant improvement over time. These findings suggest that both surgical options are effective and comparable in managing refractory lateral epicondylitis.