Carpal tunnel syndrome has become a major source of work-related impairment. Recent studies have suggested pyridoxine deficiency may be a cause of carpal tunnel syndrome, but all studies on this relationship have been flawed by lack of scientific design. Given the available evidence, pyridoxine is not likely to be a significant cause of carpal tunnel syndrome in the work place. Ergonomic measures are more likely to be effective than pyridoxine in reducing the incidence and cost of carpal tunnel syndrome in the work place.