This study evaluated the diagnostic utility and cost-effectiveness of using a handheld nerve conduction test device to test for carpal tunnel syndrome at a district general hospital. Over 9 months, 141 patients suspected of having carpal tunnel syndrome were tested using the handheld device. The results agreed with traditional nerve conduction studies in 88% of cases. Using the handheld device led to significant cost savings of £16,850 and reduced waiting times. However, 18 patients required further testing, indicating limitations and that traditional testing is still needed if other diagnoses are suspected beyond carpal tunnel syndrome.