Objective To explore the efficacy of ultrasound-guided steroid waterseparating median nerve (MN) in carpal tunnel combined with needle release the transverse carpal ligament (TCL)in the treatment of mild and moderate carpal tunnel syndrome (CTS). Methods 42 wrists were randomly divided into experimental group and control group. The experimental group was treated with steroid water separation of MN in carpal tunnel and acupuncture to release TCL. The control group was only treated with steroid water separation of MN in carpal tunnel. Assessment was performed before treatment and 3rd、6th month after treatment. Boston carpal tunnel (BCTQ) score scale (SSS, FSS), electrophysiological (SCV, DML) and ultrasonic (CSA, flattening of MN) assessment were used as evaluation indexes. 〖WTHZ〗Results The evaluation of SSS, FSS, SCV, DML, CSA and flattening of MN were improved in the experimental group and the control group after treatment (P＜0.05), and were significantly better than those in the control group 6 months after treatment (P＜0.05). Conclusion Ultrasoundguided steroid waterseparating MN in carpal tunnel combined with acupuncture release TCL is better than steroid waterseparating MN in carpal tunnel alone in treating mild and moderate CTS.