The results of open carpal tunnel release using a short incision (2.5 cm) have been compared with those following a long incision (4.5 cm) in a prospective randomized study. Eighty patients were operated upon with a follow-up rate of 100%. The variables examined included grip strength, key and pulp pinch strength, sensory function and scar tenderness. Subjective variables such as tingling, numbness and night symptoms were specifically enquired into, and time for return to work was noted. The examinations took place pre-operatively, as well as one, two, three and six weeks post-operatively. Median time for return to work was 21 days for the short incision group and 18 days for the long incision group. The long incision resulted in a significant 10% loss of strength only at week three, otherwise no significant difference was found between the results of the two groups.