Background: Conventional approach is an effective method for carpal tunnel release, however it causes scar discomfort, pillar pain and cosmetic complaints. Several mini-incision techniques were introduced to avoid such complications. Aim of the study The aim of this study is to compare the results of two surgical techniques, the conventional longitudinal incision over the transverse carpal ligament (TCL), and the mini-incision at the distal wrist crease and near the proximal border of the TCL for carpal tunnel release. Patients and Methods: This study included 20 patients with carpal tunnel syndrome. 10 were operated upon by classical open palmar incision (group A) and 10 through mini-incision technique at distal wrist crease (group B). Follow up was after 2 weeks, 1, 3 and 6 months. Incisional pain, pillar pain using Visual Analog Scale (VAS), Levine symptom and function severity scores were evaluated at 3rd and 6th months postoperatively. Patients' satisfaction about surgery and cosmetic results were evaluated using Visual Analog Patient Satisfaction Scale (VAPSS). Patients graded their cosmetic results from poor to excellent. Results: There were no intraoperative complications. Group B showed significantly less incisional and pillar pain. Patients were significantly more satisfied about cosmetic results in group B. There was no significant difference between both groups regarding time taken to return to daily life activities. Conclusion: Conventional and mini-incision surgical approaches are both safe effective methods for carpal tunnel release. Mini-incision technique provided smaller and less painful scar, hidden in the wrist crease.