The possible impact on the foetus must always be taken into account, whenever non-conservative strategies are considered in pregnancy. As to carpal tunnel syndrome, surgery is usually reserved for severe cases, or when steroid blockades have been insufficient. If only pharmacological considerations are taken into account, surgery with local anaesthetics may however be preferred over blockades. While especially lidocaine is considered quite safe in pregnancy, a foetal risk cannot be ruled out for the synthetic glucocorticoids. Moreover, the duration of exposure is considerably shorter. These issues are summarized and discussed in this review.