One hundred sixty-six patients with lateral epicondylitis were randomized to receive autologous blood injection (n=54), dextrose injection (n=57), or percutaneous perforation alone (n=55). The primary outcome was VAS pain score during provocation at 5 months. Secondary outcomes included VAS scores at rest, during activity, and after maximum grip strength; Oxford Elbow Score (OES); QuickDASH; PRTEE; and EQ-5D. Outcomes were assessed at baseline, 8 weeks, 5 months, and 1 year. Overall, the results of the study revealed no significant differences among groups in primary outcome measures, and only QuickDASH scores showed a clinically relevant improvement in the perforation and autologous blood groups compared to dextrose. These findings suggest that injectable therapies do not offer added benefit over perforation alone in treating lateral epicondylitis.