Background: The classic open carpal tunnel decompression technique, the endoscopic approach for carpal tunnel and the “mini-open" technique, representing surgical approaches for managing carpal tunnel syndrome. We study a surgical technique for carpal tunnel release using single proximal transvers skin incision and evaluate its safety and effectiveness.  
Aim of the work: To study the safety and efficacy of a proximal transverse small incision technique in management of CTS.
Patients and methods: A prospective study was conducted on twenty individuals diagnosed with CTS, the study performed at Al-Azhar University Hospitals and El-Salam General Hospital in period, between De­cember 2018 and January 2020. Patient subjected to surgical decompression using proximal transverse small incision. Post-operative patient followed for a mean period of 3 months.
Results: The current study included 20 [4 males and 16 females] patients confirmed with diagnosed as idiopathic carpal tunnel syndrome. Their age ranged between 28 to 61 years, and subjected to surgery using proximal small transverse skin incision for carpal tunnel decompression. The duration of the surgery ranged from 10-20 minute. No intraoperative complication [e.g. hemorrhage or neurovascular injury]. Three months post-operative clinical and cosmetic satisfaction were reported by all patients and no one subjected to recurrent surgery.
Conclusion: A surgical approach for carpal tunnel decompression with proximal transverse small incision at the wrist joint represent a safe, effective approach associated with low cost, less rate of complication and excellent patient satisfaction.