A large number of patients with compression of ulnar nerve at the elbow have been treated by the old method of deep anterior transposition of the nerve under the muscles of the flexor origin. Although this method has given us good results in the past, a number of patients had a deep transposition, continued to complain of local pain in the area of the postoperative scar with residual paresthesias in the ulnar nerve distribution. Of the 80 patients, 34 were females and 46 males. The ages ranged from 20 to 68 years, and follow-up from two to ten years. A new procedure was developed, performed the usual manner, a medial incision over the elbow, the ulnar nerve is exposed, freed at the ulnar groove and neurolysis is performed if indicated.The medial intermuscular septum is excised and the nerve is mobilized proximally. The nerve branches of the ulnar nerve supplying the flexor carpi ulnaris and flexor produndi of the ring and little fingers are mobilized, dissected, and retracted. The origin of the flexor muscles are dissected and V-Y plasty is performed, made like a V and then like a Y. With this method, the nerve is transposed in the new created bed, there is a 2cm of lengthening of the flexor muscles, and a wide space is created for the ulnar nerve. This space is much larger compared with the previous method. Results: Excellent 75%, and Good 25%. No fair results and no failure.