Background:Locale injections (using steroid ?a local anesthetic) for treatment of carpal tunnel syndrome (C.T.S) is widely known & studied as asafe&effective conservative way of treatment. (1,2,3,4,5,6,7,8)Aim of this study is to compare the efficacy of using each alone on treatment results Pts.&methods:77pts with (I.C.T.S) were subjected to a double blind study putting them into two comparable groups & subjecting them to local e inj.into the carpal tunnel by either steroid or local anesthetic .pts were evaluated subjectively , Objectively and electrophysiologicaly pre and one moths post injection . Results : were in favour of steroid group with significant improvement of most symptoms and signs (p<0.01) All electrophysiological abnormalities improved significantly (p<0.001) in steroid group while not in xylocain group (a part from SAP-amp.) Conclusion :It looks that steroid alone has a superior effect over xylocain alone in treating I.C.T.S by local inj.