This article represents a review of 149 carpal tunnel decompressions on 109 carpal tunnel syndrome patients, and a 22-month clinical result on endoscopic carpal ligament release. The symptoms were relieved and no permanent nerve damage, vascular complications, hematomas, infections, or recurrences were reported. Postoperatively, one patient had a temporary loss of the interosseous muscle but recovered spontaneously in 4 weeks. In this 22-month survey, 28.9% of the patients were able to return to normal activities and work within 1 week, 58.5% returned within 2 weeks, 75.4% returned within 3 weeks, and 85.9% returned within 4 weeks. A pinch-and-grip study was performed; 32% regained normal pinch-and-grip strength within 1 week, 74% regained it in 2 weeks, 93% regained it in 3 weeks, and 100% regained it in 4 weeks. Based on our results, there has been rapid recovery, less scarring, decreased postoperative pain, and no loss of pinch-and-grip strength.