Objectives Some patients with Carpal Tunnel Syndrome (CTS) complain of dropping objects. In this study, the clinical and electrophysiological features of CTS patients with (wOD) and without object dropping (w/oOD) were compared. Methods 52 female cases (age range: 21–80) consisting of 20 wOD, 16 CTS w/oOD patients and 16 healthy controls were included. Clinical evaluation included neurological examination, hand preference questionnaire, Boston Carpal Tunnel Syndrome Questionnaire (BCTQ), a questionnaire for frequent object dropping and records of weekly hand usage. Nerve conduction studies (NCSs) were composed of bilateral orthodromic median 2nd finger and ulnar 5th finger sensory NCSs, median-ulnar ring finger sensory latency comparison, and median and ulnar motor NCSs. Median nerve was stimulated at palm, wrist and elbow. Conduction velocity and compound muscle action potential (CMAP) amplitude loss across the wrist was calculated. Results In wOD cases, mean age was older (59 vs. 53 years), symptom duration (42 vs. 29 months) and weekly occupational hand usage times (47 vs. 39 h) were longer, BCTQ symptom severity (2.9 vs. 2.5) and functional status scores (3.1 vs. 2.4) were higher. Sensory and motor NCSs abnormalities were more prominent on the dominant side in wOD, while they were similar on the non-dominant side in both groups. CMAP amplitude loss across the wrist was higher on the dominant side in wOD (27.8% vs. 13.3%). Discussion and conclusion Frequent object dropping may be a sign of severity and chronicity in CTS. Significance The relation between frequent object dropping and clinical and electrophysiological severity of CTS was investigated.