Carpal tunnel syndrome (CTS) is one of the most common peripheral nerve diseases. It is managed medically and if not, resolved by surgical procedure. Decompression of the carpal tunnel is considered the definitive treatment. There are multiple complications after this procedure, which can be classified into three categories: (I) persistent, (II) recurrent, or (III) new symptoms, and ulnar nerve palsy after decompression of the carpal tunnel is a rare complication. In this study, we present a case of carpal tunnel decompression, which was complicated by ulnar nerve palsy, which exacerbated a pre-existing chronic ulnar nerve injury. We also explore the possible causes that may have led to this outcome.
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