Thoracic outlet syndrome (TOS) is a complex entity that is characterized by different neurovascular signs and symptoms involving the upper limb. TOS can be difficult to diagnose because there is no standardized objective test that can be used and the clinician must rely on history and several positive findings on physical exam. Electrophysiological study is useful in the diagnosis of neurogenic TOS.Reduced amplitude of medial antebrachial cutaneous nerve and ulnar nerve sensory nerve action potentials (SNAPs), predominant denervation in thenar eminency, and reduced amplitude of compound motor action potentials (CMAPs), more by median than by ulnar stimulation, are correlative with the diagnosis. Electromyographic studies showed a reduced recruitment pattern of motor unit activation in intrinsic hand muscles. Especially, electrophysiological assessment can help exclude conditions that may mimic nTOS, such as ulnar nerve entrapment or cervical radiculopathy.