Pronator syndrome is the most proximal entrapment neuropathy of the median nerve. Compression can occur at one of several anatomic locations in the elbow region. It is extremely rare in comparison with carpal tunnel syndrome, which presents with similar sensory symptoms. Electrodiagnostic studies are often normal, and objective findings can be difficult to demonstrate clinically, particularly if they are related to activity. The condition is misdiagnosed frequently, and many patients undergo unsuccessful operations before the correct diagnosis is made. Timely diagnosis and treatment are required to prevent progression to a more permanent condition.