The effects of local hydrocortisone acetate injections in patients with a carpal tunnel syndrome are reported. In a prospective study of sixty one wrists injected, fifty five (90%) had initial symptomatic relief. At review after one year forty one wrists had relapsed (67%) requiring decompression. In view of the poor long term response to injection it was decided to test the accuracy of the sitting technique in a separate consecutive series of twenty six wrists at operation. The needle was found to be correctly sited in twenty four wrists (92%). It is suggested that, as initially considerable symptomatic relief can be achieved, the principal value of steroid injections lies as a palliative remedy whilst decompression is awaited.