Introduction: School teachers are prone to various occupational problems especially musculoskeletal disorders including carpal tunnel syndrome (CTS) which may cause sick leave, absenteeism and early retirement leading to decreased productivity at work. In developing countries, a paucity of researches was done in this field. Aim of work: To assess the prevalence and the risk factors of CTS among symptomatic school teachers in Menoufia, Egypt. Materials and methods: A cross-sectional study of symptomatic school teachers at the Physical Medicine, Rheumatology and Rehabilitation Department, Menoufia University Hospital from January to October 2018. A selfadministered questionnaire including participants' personal, occupational and pain information were used. Also, nerve conduction studies were done of both right and left median nerves including motor and sensory. Results: One hundred and eighty seven school teachers responded to the study. The prevalence of CTS was reported by 62% of symptomatic teacher. Both hands of CTS teachers had significantly higher mean latency and lower amplitude and nerve conduction velocity of motor and sensory nerve studies when compared to non CTS one. The severity of carpal tunnel syndrome in both hands of CTS teachers was mainly moderate grade. The CTS was significantly prevalent among female school teachers and primary or secondary level of school. A combination of risk factors: body mass index, school level, working duration, working hours per day and working computer hours per day; were found to be significantly associated with increasing CTS. Conclusion and recommendations: The symptomatic school teachers had high prevalence of CTS which is affecting their work and education system as a whole. An implement intervention programs is needed by the higher authorities to address this issue. An adequate care, ergonomic rules and exercise program have to be recommended so as to alleviate this disorder.