Objective: The purpose of this literature review was to determine the role of nerve conduction studies and ultrasonography in the diagnosis of carpal tunnel syndrome. Methods: A search of the current literature was performed, leading to the inclusion of 17 suitable papers for analysis. The outcomes of these papers were used to outline a better understanding of the role of ultrasonography in the diagnosis of carpal tunnel syndrome when compared to the gold standard of nerve conduction studies. Results/Discussions: Clinical and neurophysiological examinations are important in diagnosing CTS. At this stage NCS are still the gold standard diagnostic tool in the diagnosis of CTS, however information must be applied appropriately to the clinical scenario at hand. Conclusion: Nerve conduction studies remain the gold standard for the diagnosis of carpal tunnel syndrome; however there are many new studies emerging that demonstrate the benefits of ultrasonography in the diagnosis of CTS, importantly when considering cost effectiveness, availability, and accuracy.