A retrospective study was done to determine why a meat packing plant in Illinois had such an unusually high incidence of carpal tunnel syndrome. In the past 12 years, 14.8% of employees at this plant have had a carpal tunnel release. Only two of 117 patients remained unimproved at an average follow-up of 37.4 months. The most consistent result after release was relief of the paroxysmal attacks of burning pain and paresthesia. Weakness of grip was the most significant postoperative complaint in 78%. Highly repetitive motions involving extreme wrist positions, especially flexion and ulnar deviation while grasping, are predominant in meat cutting and probably contribute to the development of carpal tunnel syndrome in this industry. Previous reports of industrial carpal tunnel syndrome have not approached the incidence identified in this study. Patient awareness and Workers' Compensation benefits may account for the high numbers seeking treatment.