The authors present their experience with 35 cases of radial tunnel syndrome, which is caused by compression of the posterior interosseus nerve in the proximal dorsal forearm related to exertion. Chronic aching muscle pain is the problem. Real paralysis is very rare, and is usually considered as a separate entity. The syndrome is often confused with tennis elbow, although the patient may have both problems. The diagnosis remains clinical, and surgical decompression of the nerve in the region of the supinator will give relief in most cases.