Carpal Tunnel Syndrome is the most common entrapment neuropathy in the upper extremity. The median nerve is compressed within its course through the carpal Tunnel just distal to the wrist crease. Usually Occur in middle aged patients Ratio of female to male = 4 : 1. It is bilateral in over 50 % of cases, but is usually worse in the dominant hand. The anatomy of carpal tunnel present a unique model for the entrapment neuropathy, because of crowded arrangement of structures passes through the tunnel, any tenosynovial proliferation , wrist joint abnormality , tumor or muscular anomaly can lead to the syndrome . Early diagnosis and treatment are important and result in complete cure , delay can result in irreversible median nerve damage. Usually the carpal tunnel is considered an inflammatory disorder caused by repetitive stress , physical injury , or other condition that cause the tissues around the median nerve to become swollen .