To compare the effectiveness of radial extracorporeal shock wave therapy (r-ESWT) and corticosteroid iontophoresis (CI) in patients with carpal tunnel syndrome (CTS). Material and Methods: This randomized prospective study included a total of 72 wrists diagnosed with CTS of 54 patients with a mean age of 42.2±8.7 years (range, 22-59 years). The patients were randomly separated into two groups. Group 1 (n=37) received r-ESWT, and Group 2 (n=35) received CI. Evaluations were made at baseline and at 0, 1 and 3 months after treatment using the visual analog scale (VAS), Boston Symptom Severity Scale (BSSS), Boston Functional Capacity Scale (BFCS), grip strength, and electrophysiological examination. Results: Compared to baseline, the VAS, BSSS, BFCS, grip strength values at the 0, 1 and 3 months after treatment improved significantly in both groups (all p<0.001). However the nerve conduction study results were significantly improved only in r-ESWT group (all p<0.001). When the change levels were compared between the groups, the decrease in VAS (all p<0.001), the improvement in BSSS (p=0.029, p=0.023 and p=0.040, respectively), BFCS (p<0.001, p=0.001 and p<0.001, respectively), grip strength (all p<0.001), sensory nerve conduction velocity (p=0.001, p<0.001 and p<0.001, respectively) and distal motor latency (p=0.001, p=0.001 and p<0.001, respectively) before and at 0, 1 and 3 months after treatment were significantly higher in the r-ESWT group than the CI group. Conclusion: This study revealed that both methods were useful in alleviating pain and improving function in CTS, however r-ESWT seems to be more effective than CI.