Carpal tunnel syndrome (CTS) is a clinical syndrome diagnosis. There is no universal reference test for diagnosing CTS. In case of a clinical presentation consistent with the typical characteristics of CTS, the diagnosis can be made without additional examinations. In that case, the physician may immediately proceed with a discussion of treatment options with the patient, using the CTS consultation card. Use of clinical provocation tests, questionnaires and hand diagrams is not advised due to their limited diagnostic value. Additional examinations are indicated when a patient does not have all typical characteristics of CTS or when in doubt about the diagnosis. If available, nerve ultrasonography is the test of preference but nerve conduction tests are a good alternative. From the perspective of quality of care, patient-friendliness and efficiency, it is recommended to make arrangements between primary and secondary care about the care process for patients suspected of having CTS.