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4% vs 31.7%, P = 0.03). Patients with mild, moderate and severe grades, respectively, required an average of 1.7 (0.1), 2.4 (0.2) and 2.6 (0.3) injections to reach an effective outcome (P = 0.006) (severe vs mild, P = 0.008; moderate vs mild, P = 0.062). Perineural injection therapy is a novel approach for treatment of carpal tunnel syndrome with safe and outstanding long-term effects. Perineural injection therapy is a novel approach for treatment of carpal tunnel syndrome with safe and outstanding long-term effects. To evaluate the in