We prospectively studied preoperative and postoperative grip and pinch strength in 21 patients having 30 consecutive median nerve decompressions for carpal tunnel syndrome. All procedures were done by one surgeon. Each hand operated on served as its own control and was studied by the same therapist preoperatively and at monthly intervals for 6 months after the procedure. An initial decline in both grip and pinch strength was noted in most hands during the first postoperative month. Eighty percent or more grip strength was regained in 65% of the hands at 2 months and in 81% at 3 or more months. In those hands (65%) that regained at least 100% of their preoperative grip strength at 3 or more months, there was an average increase in maximal grip of 56%, as compared with an average decrease of 20% in the remaining hands (35%).