Background: Administration of platelet-rich plasma (PRP) via injection has demonstrated enhancements in the clinical outcomes for individuals afflicted with mild to moderate cases of carpal tunnel syndrome (CTS). This research compared the injection efficiency of PRP versus corticosteroids intra-carpal under the guidance of ultrasound for CTS treatment. Methods: A randomized, prospective, controlled, double-blind study encompassed 66 patients, both sex, ranging in age from 20 to 80 years, exhibiting unilateral or bilateral mild to moderate CTS, classified electrophysiologically, with symptomatic manifestations persisting for a minimum of 3 months, corroborated by electrophysiological assessment. The participants were segregated into three equal cohorts: Group I received medical treatment with gabapentin 100 mg thrice daily; Group II underwent intra-carpal PRP injection; and Group III received intra-carpal corticosteroid injection. Results: An inverse correlation was observed between nerve conduction and body mass index (BMI) (P=0.007), while a positive correlation existed between nerve conduction and PRP (P=0.035). The Boston Carpal Tunnel Questionnaire (BCTQ) scores, encompassing both symptom severity (BCTQs) and functional status (BCTQf), were significantly lower in Groups (Ⅱ, Ⅲ) compared to Group I at 1 month and 2 months (p<0.05). Furthermore, BCTQs and BCTQf scores were markedly lower in Groups (Ⅱ, Ⅲ) than in Group I at 3 months and 4 months (p<0.05). The consumption of pregabalin and acetaminophen was significantly reduced in Groups (Ⅱ, Ⅲ) relative to Group I throughout the 4 th -6 th , 6 th -8 th , 8 th -10 th , and 10 th -12 th weeks, as well as during the 3 rd -4 th month and 4 th -5 th month (p<0.05). Conclusions: High efficacy of both steroids and PRP in CTS compared to medical treatment using gabapentin, both Steroids and PRP showed the same efficacy in CTS treatment regarding numerical rating scale BCTQs, BCTQf as well as nerve conduction study.