5:10 % of cases of lateral epicodylitis are resistant to conservative treatment and need surgical intervention.The purpose of this study was to evaluate the clinical outcomes of Modified Nirschl techniques for treatment of tennis elbow .An Prospective case arrangement contemplate might have been intended between february 2019 What's more january 2020 including 20 patients from outpatient facility from claiming Benha school healing center enduring starting with safe horizontal epicondylitis. Nitty gritty therapeutic history, clinical examination and PRTEE score connected will every one patients pre and post-operatively. There were 8 female What's more 12 male patients in the ponder. The mean span about indications in the recent past surgery might have been 14. 3 months. Those Normal span from claiming catch up might have been 28 months. We found that the changed Nirschl system need swaying brings about administration of horizontal epicondylitis clinched alongside (95%) of instances for An imply about 4 weeks period should profit on typical exercises Furthermore 15. 3 weeks will resume overwhelming exercises without agony. Those aggregate PRTEE score moved forward from a mean for 67 focuses to a intend of 6 focuses postoperatively. Those altered Nirschl system allotments almost equivalent comes about for different methods ,although those patients profit to their exercises after the fact over the opposite strategies. Additionally this strategy need favorable element of beneficial visualization of the entire degenerated tissues guaranteeing flawless debridement. Therefore, we recommended this choice following fizzled preservationist oversaw economy of horizontal epicondylitis.