Forty-eight renal hemodialysis patients were evaluated clinically and electrodiagnostically for carpal tunnel syndrome (CTS). The incidence (32%) was significantly higher than that previously reported by other authors. All patients with CTS also had peripheral neuropathy by electrodiagnostic criteria. CTS was found four times as often in patients who had dialyzed longer than five years compared to those who had dialyzed less than five years. Patients with CTS were more likely to have an active or inactive access in the involved forearm than were patients without CTS. In patients with CTS treated by transverse carpal ligament release, 87.5% obtained relief from pain and numbness. Because of the high incidence of CTS in the chronic hemodialysis population, electrodiagnostic screening is recommended in these patients. Patients with clinical and electrodiagnostic signs of CTS will benefit from transverse carpal ligament release.