Background This study analyzed outcomes of radiofrequency microtenotomy coblation using the TOPAZ coblation wand (ArthroCare, Sunnyvale, CA) paired with arthroscopic synovectomy of the radiocapitellar joint for lateral epicondylitis. The goal of this study was to evaluate the rates of patients’ early recovery and decrease in pain. Methods The authors followed 40 patients who underwent surgery at one institution since January, 2004. Patients were asked to fill out questionnaires regarding their preoperative and postoperative pain at set intervals and were asked to rate their function and satisfaction with the treatment. Results Results indicated a rapid decrease in pain postoperatively with a persistent average drop of 7.7 points (on a visual analog scale of 0–10) at 6 months after the operation. Mayo Elbow Performance Score results improved from an average of 55 to 95. Conclusions These results represent significant early improvement over other existing surgical techniques. The results have been maintained for a minimum of 1 year, and up to 4 years, postoperatively.