The aim of this study was to explore the impact of carpal tunnel syndrome (CTS) on individuals and their expectations of surgical decompression to identify what outcome domains need to be assessed in future clinical trials. This qualitative study used in-depth, face-to-face interviews with nine patients with CTS awaiting surgical decompression. The tape-recorded interviews were transcribed fully, data were coded and categorized independently by two researchers and emerging themes were identified. Patients identified relief of symptoms-tingling, numbness and sleep disturbance, and resumption of important activities-as their most important criteria for judging the success of surgery. Although they recognized the consequences of this disorder were minor in comparison to more serious diseases, patients expressed distress at the impact of this disorder on their quality of life and expressed hope that surgery would address this. The assessment of outcomes of surgical decompression of CTS needs to include measures of symptom resolution as well as of activity limitation and participation restriction. Using existing patient-rated, disease-specific, and region-specific outcome instruments is likely to capture those domains which patients consider important criteria of success.