Background: Symptoms related to carpal tunnel syndrome (CTS) represent common patient complaints for many primary care physicians. However, there is a surprising lack of guidelines on diagnosing occupational CTS readily accessible to primary care physicians. This article aims to fill part of that void by reviewing historical aspects of occupational CTS, leading up to more current epidemiologic studies of the association of CTS with occupational ergonomic risk factors.Methods: The English medical literature was reviewed on the relationship between CTS and occupational ergonomic risk factors. Recent legislative initiatives are discussed. Guidelines of diagnosing and managing occupational CTS are outlined.Results: Many studies are divided regarding whether CTS is associated with highly repetitive/forceful/ vibration work. However, a subset of patients presenting with symptoms related to CTS probably has occupational CTS. These patients can be objectively diagnosed and successfully treated and are able to return to work.Conclusions: By being armed with knowledge regarding the background of CTS and by following simple diagnosis and treatment guidelines, the family practitioner should be able to manage many patients presenting with work-related CTS.