A selected group of 23 patients underwent surgery for iliotibial band friction syndrome. Among the patients presenting with this exertional pain syndrome were runners, football players, and cyclists. Diagnosis was clinical since radiographs were negative and an ultrasound examination was positive in only one case, showing an aberrant picture around the lateral femoral epicondyle. Although conservative treatment is effective in most cases, an alternative is needed for patients with complaints that are resistant to conservative means. Surgery was done with the knee held in 60 degrees of flexion and consisted of a limited resection of a small triangular piece at the posterior part of the iliotibial band covering the lateral femoral epicondyle. The uniform good results, low morbidity, and quick return to sports demonstrate that this type of surgery offers a solution for selected cases of failed prolonged conservative treatment.