Sonoelastography is a novel ultrasound (US) tool of portraying the strain properties of biological tissue. The carpal tunnel syndrome (CTS) may cause structural and elastic distortion of the median nerve (MN). We wanted to see how B-mode ultrasound and strain elastography differed between the CTS patient population and healthy individuals, as well as how they correlated with nerve conduction investigations (NCS). Methods: There were 100 wrists in this prospective study from 57 people with clinically confirmed CTS, and 110 wrists in this study from 55 healthy, non-diseased individuals. Patients with CTS had their neck circumference measured (NCS). The CSA of the MN at the wrist, the wrist-to-forearm ratio (WFR), and the flattening ratio (FR) were measured, and the MN's echogenicity and mobility were evaluated, in both the patient and control groups. Strain elastography was used to assess the MN's elasticity. The MN at the wrist was significantly stiffer in CTS patients than in healthy controls (p 0.001). Compared to the control group, the MN CSA-D, WFR echogenicity, and mobility of the CTS participants were all statistically substantially different (p0.001). This study found a statistically significant association between the elastic ratio and the MN distal motor delay and a statistically significant correlation between the elastic ratio and the sensory amplitude and conduction velocity. When it comes to NCS neurophysiology, the MN elastic ratio was shown to have a positive connection (r=0.252, p-0.011) with the neurophysiological grades. Sonoelastography in CTS demonstrated strong relationships with NCSs. Using sonoelastography in CTS was shown to be both useful and practicable in this investigation.