Sixty patients with chronic lateral elbow pain were randomized to receive a single session of either real ultrasound-guided percutaneous electrical nerve stimulation (US-PENS) targeting the radial nerve (n=30) or sham US-PENS (n=30). The primary outcome measured was pressure pain threshold. Secondary outcomes included pain intensity, pain-free grip strength, and self-perceived improvement. Outcomes were assessed immediately following the intervention. Overall, the results of the study revealed significant reductions in pain intensity and higher proportions of moderate to large self-perceived improvements with real US-PENS compared to sham. No significant differences were observed in pressure pain thresholds or between-group pain-free grip strength. These findings suggest that a single session of US-PENS targeting the radial nerve can effectively decrease immediate pain perception and enhance subjective improvement in patients with lateral elbow pain.