PURPOSE: To find out the clinical usefulness of carpal tunnel release with open minimal incision MATERIALS AND METHODS: We studied 149 patients (152 carpal tunnel) who were able to follow up for more than 6 months after being treated with carpal tunnel release with open minimal incision from January 2000 to January 2006. We compared the clinical results of this procedure using recovery time, the disappearance of symptoms, the presence of the kelloid and the scar tenderness and analyzed preoperative and postoperative VAS score of tingling sensation, dull sensation, inappropriate hand movement, muscle weakness, edema, palmar pain as subjective satisfaction. We used the independent t-test for the statistical significance. RESULTS: All cases had complete disappearance or marked improvement in symptoms, and there was no kelloid formation. Residual symptoms and tenderness of the scar was found in 8 cases (5.4%), but gradually disappeared. In last follow up, tingling sensation decreased from 7.8 to 1.0 and dull sensation from 7.0 to 1.5, inappropriate hand movement from 4.8 to 1.1, muscle weakness from 5.9 to 0.8, edema from 2.0 to 0.5, palmar pain from 2.1 to 0.2 in preoperative and postoperative VAS score, all were significantly improved statistically (P<0.05). CONCLUSIONS: We think that carpal tunnel release with open minimal incision has little complication and is a safe and effective operation method having similar effect with endoscopic surgery or conventional open surgery.