Tennis elbow surgery, medically known as lateral epicondylitis release, is performed to relieve chronic pain on the outside of the elbow caused by degeneration and tearing of the extensor tendon, most commonly the extensor carpi radialis brevis (ECRB). This condition develops from repetitive overuse rather than inflammation alone, leading to weakened, scarred tendon tissue that fails to heal. Surgery is considered only after prolonged nonsurgical treatment — such as rest, physical therapy, bracing, medications, or injections — has failed to provide relief for at least 6 to 12 months. Before surgery, patients undergo a clinical examination and sometimes imaging studies to confirm the diagnosis and rule out other causes of elbow pain. Tennis elbow surgery is typically performed as an outpatient procedure under local anesthesia with sedation or general anesthesia. The goal of surgery is to remove damaged tendon tissue, reduce tension at the tendon’s attachment to bone, and stimulate a healthy healing response. There are several surgical approaches. Open surgery involves a single incision over the outside of the elbow, allowing direct access to the diseased tendon. Arthroscopic surgery uses small incisions and a camera to visualize and remove damaged tissue in a minimally invasive manner. In select cases, percutaneous techniques using small punctures may be used. During the procedure, the surgeon removes degenerated tendon tissue, may scrape or smooth the bone surface, and occasionally removes bone spurs that contribute to irritation. Healthy tendon tissue may be reattached to bone or released slightly to reduce mechanical stress. After surgery, the arm is typically placed in a soft dressing or brace. Early recovery focuses on pain control and protecting the repair, followed by gradual restoration of motion. Physical therapy plays a critical role and usually begins within weeks, progressing from gentle range-of-motion exercises to strengthening over time. Most patients return to basic daily activities within 3 to 6 weeks, but full recovery — including return to sports or heavy manual work — can take 3 to 6 months or longer. Surgical outcomes are generally favorable, with most patients experiencing significant pain relief, though some loss of strength can occur.