Ninety-seven patients undergoing treatment for advanced cubital tunnel syndrome were randomized to receive either ulnar nerve decompression and transposition with supercharged end-to-side motor nerve transfer (n=47) or ulnar nerve decompression and transposition alone (n=50). The primary outcomes of this trial were to assess the predictive factors for poor recovery as well as describing the nerve transfer procedure through a small incision. The results of this trial illustrated that ulnar nerve decompression and anterior subfascial transposition with supercharged end-to-side anterior interosseous nerve-to-ulnar motor nerve transfer is superior to the standard treatment when considering pinch strength, compound muscle action potential (CMAPa) of the first dorsal interossei and abductor digiti minimi. Functional scores status scores were found to be superior in the DAST with AIN group when compared to the control.