Seventy women with unilateral carpal tunnel syndrome were randomized to receive either ultrasound-guided percutaneous electrical nerve stimulation (PENS) (n=35) or endoscopic surgical decompression (n=35). The primary outcome of interest was hand pain intensity (mean and worst pain). Secondary outcomes included functional status, symptom severity (measured by the Boston Carpal Tunnel Questionnaire), and self-perceived improvement. Outcomes were assessed at baseline, and at 1, 3, 6, and 12 months. Overall, the results of the study revealed that PENS led to greater short-term improvements in pain and function than surgery, but outcomes were similar between groups by 12 months. These findings suggest that PENS is a viable conservative alternative to surgery for short-term relief in CTS.