One hundred and eight (n=108) upper limbs with mild–to–moderate of cubital tunnel syndrome (CuTS) were randomized to neurodynamic manual therapy (sliding/tensioning techniques; n=54) or electrophysical modalities (low-level laser + ultrasound; n=54). The primary outcomes were ulnar motor conduction velocity and ultrasound measures (cross-sectional area and shear modulus). Secondary outcomes included static two-point discrimination, cutaneous sensory perception thresholds, pain (day/night), Q-DASH, S-LANSS, and global rating of change; outcomes were collected at baseline, post-treatment (after 10 sessions over 2 weeks), and 6 months. Overall, the results of the study revealed clinically and statistically significant within-group improvements for both arms, with between-group advantages favoring manual therapy for nerve conduction, ultrasound metrics, sensory discrimination, and perception thresholds. In short, both strategies were effective conservatively, but neurodynamic manual therapy produced larger objective gains.