Eighty-three patients with refractory tennis elbow were randomized to receive surgical treatment via the Nirschl technique or leukocyte-rich platelet-rich plasma (L-PRP) injection. The primary outcome of interest was the pain sub-score on the Patient-Rated Tennis Elbow Evaluation (PRTEE) scale. Secondary outcomes of interest included the PRTEE function and PRTEE total scores, as well as the Disability of the Arm, Shoulder and Hand (DASH) score and DASH work scores. Follow up was performed up to 1 year post-treatment. Study findings revealed significantly greater improvements from baseline in the PRTEE pain score in favour of the surgical group compared to the L-PRP group. No significant differences in the change from baseline in all secondary outcomes were observed between the two groups.