21 randomized controlled trials, with a total of 1859 hands, were analyzed in order to compare endoscopic release to open release in patients with carpal tunnel syndrome. Pain, strength, digital sensibility, complications, and return to work were among the outcomes included. Pooled results indicated that patients who had undergone endoscopic release displayed significantly greater strength over the first 6 postoperative months, earlier return to work, and lower risk of scar tenderness. However, patients who underwent endoscopic release were also at significantly greater risk of experiencing nerve injury. Additionally, no difference in strength was noted after 6 months post treatment.