Background There is no consensus on the most effective surgical technique in the treatment of cubital tunnel syndrome. Anterior subcutaneous transposition (AST) and anterior intramuscular transposition (AIT) are common surgical treatments in this regard. The aim of this study was to compare the clinical outcomes of these two surgeries for cubital tunnel syndrome. Methods In a retrospective study, we compared surgical outcomes (pain, sensation, motor recovery, atrophy, and total satisfaction) in 40 patients undergoing AIT and 43 undergoing AST of the ulnar nerve. Results The patients undergoing AIT showed a significant improvement in all the outcomes after the surgery (P=0); however, those undergoing AST only experienced an improvement in pain and sensation after the surgery (P=0). Comparing the two surgeries, we found that there was a high total satisfaction with AIT compared with AST (P=0). When we independently compared each outcome in the two groups, we found that the muscle force recovery was significantly improved in the AIT group compared with the AST group (P=0). Conclusions AIT is preferable to AST for the surgical treatment of cubital tunnel syndrome. In particular, AIT achieves a better motor recovery of the ulnar nerve compared with AST.