Cubital tunnel syndrome is one of the most frequent causes of painful paresthesias in the upper extremity. As the ulnar nerve travels around the elbow, it is subjected to compressive, tensile, and frictional forces that potentially jeopardize its physiologic function. A detailed physical examination remains the primary mode of diagnosis. Recently, high-resolution ultrasound has garnered enthusiasm as an additional diagnostic and prognostic tool. With mild symptoms, many patients can be effectively treated conservatively. In advanced stages, surgical intervention should be recommended. Continued advancement in surgical techniques now allows several equally effective alternatives for both primary and recurrent cubital tunnel syndrome.