Background <p>Carpal tunnel syndrome (CTS) is a common entrapment neuropathy of the upper extremity. Treatment includes various conservative methods.</p> Aims <p>This study investigated the effects of radial extracorporeal shockwave therapy (rESWT) and kinesio taping (KT), alone and combined, compared to exercise therapy on pain, quality of life, hand function, and ultrasonographic median nerve cross-sectional area (CSA) in CTS.</p> Methods <p>Patients with mild to moderate CTS were randomized into four groups: Group 1 (rESWT + KT), Group 2 (rESWT), Group 3 (KT), and Group 4 (exercise only). The first three groups received weekly treatments for 3 weeks. Assessments included pain (NRS), neuropathic complaints (DN-4), grip/lateral pinch strength, symptom severity (BCTQ, DHI), quality of life (NHP), and median nerve CSA. Evaluations were conducted pre-treatment, at week 3 and week 6.</p> Results <p>Seventy-six patients were included. Pain and paresthesia VAS scores significantly improved in all treatment groups (<i>p</i> &lt; 0.05). BCTQ-SSS, grip strength, and lateral pinch strength improved significantly in Groups 1–3 compared to Group 4 (<i>p</i> &lt; 0.05). CSA decreased significantly in Groups 1–3 (<i>p</i> &lt; 0.05), with no differences between them. DHI and DN-4 scores improved in all groups (<i>p</i> &lt; 0.05). NHP scores improved significantly only in Group 1 (<i>p</i> &lt; 0.05).</p> Conclusion <p>rESWT and KT, alone or combined, effectively improve pain, function, and CSA in CTS. Their combination is superior to exercise therapy alone.</p>