Occupational carpal tunnel syndrome is estimated to affect 1.89 million workers in the United States. Carpal tunnel surgery is one of the most common operations performed on the hand. For patients with injuries covered by Worker's Compensation, hand surgeons are asked to provide an impairment rating. We retrospectively reviewed records of patients with carpal tunnel syndrome from 1997 through 2001. During this five-year period 1,974 carpal tunnel operations were performed, of which 253 were on patients covered by Worker's Compensation. Once patients reached maximum medical improvement, a permanent partial impairment rating was performed. Of these patients, 37 had unilateral carpal tunnel syndrome exclusive of other hand or extremity diagnoses. The average impairment rating assigned to this group of patients was 3.26%. In our experience, we feel that patients with only unilateral carpal tunnel syndrome can be confidently assigned an impairment rating of less than five percent after maximum medical improvement following surgery.