Despite the widespread use of carpal tunnel syndrome (CTS) surgery, it remains a clinically controversial area due to persistent symptoms, recurrence, and complications related to surgery. In the literature, complication rates after carpal tunnel release (CTR) range from 2% to 25%. The most common problems are pillar pain, persistent symptoms, and recurrent carpal tunnel syndrome. Although major nerve injuries are rare, they are among the most serious complications. Clinical improvement rates in patients undergoing revision surgery are reported to be between 60% and 80%. The vast majority of complications seen in KTS surgery are preventable. Appropriate patient selection, detailed anatomical knowledge, careful surgical technique, and structured rehabilitation programs are the main factors determining surgical success. In persistent and recurrent cases, revision surgery supported by a multidisciplinary approach and modern imaging methods can provide effective results. This compilation aims to comprehensively evaluate early and late complications observed in CTS surgery, their pathophysiological bases, risk factors, and current management strategies, based on published studies regarding complications of open, endoscopic, and ultrasound-guided carpal tunnel release (USG-guided CTR) techniques, revision surgery approaches, and long-term clinical outcomes.