ABSTRACTIntroduction: We examined whether lifestyle factors differ between patients with ulnar neuropathy confirmed by electroneurography (ENG) and those with ulnar neuropathy‐like symptoms with normal ulnar nerve ENG. Methods: Among patients examined by ENG for suspected ulnar neuropathy, we identified 546 patients with ulnar neuropathy and 633 patients with ulnar neuropathy‐like symptoms. These groups were compared with 2 separate groups of matched community referents and to each other. Questionnaire information on lifestyle was obtained. The electrophysiological severity of neuropathy was also graded. We used conditional and unconditional logistic regression. Results: Responses were obtained from 59%. Ulnar neuropathy was related to smoking, adjusted odds ratio (OR) 4.31 (95% confidence interval [CI] 2.43–7.64) for >24 pack‐years. Ulnar neuropathy‐like symptoms were related to body mass index ≥30 kg/m2, OR 1.99 (95% CI 1.25–3.19). Smoking was associated with increased severity of ulnar neuropathy. Conclusions: Findings suggest that smoking specifically affects the ulnar nerve. Muscle Nerve 48: 507–515, 2013