Surgical treatment of ulnar tunnel syndrome remains controversial with no consensus on the ideal procedure. Nevertheless, in situ decompression seems to have a faster recovery with less morbidity compared to neurolysis-transposition. We present the different aspects of the pathology and the prerequisites necessary for the ultrasound-guided release. The release is done under ultrasound guidance and local anesthesia. The section starts below Osborne’s arcade. The section is done under full-time ultrasound guidance. The skin incision does not need any nurse dressing and patients are encouraged to get as fast as they can to their daily activities. Overall this new ultrasound-guided percutaneous technique for ulnar nerve entrapment is a safe procedure, allowing rapid recovery with effective symptom relief while limiting the risk of complications and time out of work.