Ultrasound-guided surgery is a new trend resulting from the introduction of high-frequency linear probes and higher-quality screens. Surgical treatment of carpal tunnel syndrome is increasingly being performed under ultrasound guidance. Knowledge of musculoskeletal ultrasound is, of course, essential. Several types of cutting instruments (miniature knife, Gigli saw or hook) and surgical approaches (wrist or palm) have been described. Ultrasonography allows the use of the wide awake and local anesthesia with no tourniquet (WALANT) technique in the outpatient setting. The purpose of this article is to report our experience with retrograde percutaneous ultrasound-guided techniques.