Guyon's canal syndrome is a compression neuropathy of the ulnar nerve entrapment 
at the wrist. Compression of the ulnar nerve at the wrist by a ganglion, 
lipomas, diseases of the ulnar artery, fractures of the hamate and trauma are 
common etiologcal factors. Unlike Guyon's canal syndrome, carpal tunnel syndrome 
(CTS) is the most common nerve entrapment of the upper extremity. Although, open 
(OCTR) or endoscopic carpal tunnel release (ECTR) is highly effective in 
relieving pain, failure with carpal tunnel release is seldom seen. In this 
paper, we presented a patient with ulnar nerve entrapment associated with 
recurrent CTS and discussed the possible pathomechanism with a review of current 
literature.