Seventy-four participants (eighty procedures) with carpal tunnel syndrome were randomized to deep LA infiltration (n=38) or superficial LA infiltration (n=42). The primary outcome was presence and severity of pain (and tingling) during LA infiltration and during the procedure, assessed immediately post-Carpal tunnel release (CTR). Secondary outcomes included VAS pain at 2, 8, and 24 hours, and Boston Carpal Tunnel Questionnaire (BCTQ) at baseline and 3 months. Overall, the results of the study revealed no statistically significant differences between deep and superficial techniques for pain during infiltration or during the procedure, nor for early postoperative pain; both groups had marked and similar improvements in BCTQ at 3 months. These findings suggest superficial infiltration—being technically simpler and avoiding theoretical median-nerve risk—is a reasonable default for CTR under wide awake local anesthetic no tourniquet (WALANT).