The electrodiagnostic records of 49 patients with ulnar neuropathy at the elbow (UNE) on at least one side were reviewed. Of these, 18 (36.7%) had contralateral and 1 (2.0%) had probable contralateral involvement, for a total of 19 patients (38.8%) with bilateral UNE. The upper extremity presenting symptoms were unilateral in 13 (68.4%) of the patients with bilateral UNE. Differences in associated clinical history data and concurrent electrodiagnostic findings were not clinically or statistically significant between the unilateral and bilateral UNE groups. This pilot study suggests the incidence of UNE bilaterality may be high in some populations and that, when UNE is encountered electrodiagnostically, the contralateral extremity should also be tested. Further studies to determine what factors are related to the bilaterality of UNE appear indicated.