In differential diagnosis of foot pain the tarsal tunnel syndrome has to be considered. Only few publications concerning clinical signs, diagnostic means, especially electrophysiological methods and postoperative long term results can be found in literature. In this study 21 of 32 patients who had a decompression operation of the posterior tibial nerve between 1972 and 1995 were reexamined at an average follow-up time of 12 years. Electrodiagnostic evaluation and clinical results by time of follow-up were compared to preoperative findings. Using the criteria described by Kaplan 10 postoperative results were rated as very good, 6 as good and 5 as poor. Sensible neurography has proven the most sensitive electrodiagnostic method. In the majority of cases the tarsal tunnel syndrome is still a clinical diagnosis.