Twenty-eight patients with concurrent carpal-tunnel syndrome and Raynaud's phenomenon or acrocyanosis were studied. Fifteen had a definite diagnosis or presumptive evidence of a systemic disease. Thirteen patients were treated conservatively and fifteen had decompression of the transverse carpal ligament. All patients treated surgically had an excellent result in regard to the carpal-tunnel symptoms, whereas in the group treated conservatively only three showed improvement. Six patients treated surgically had excellent or good results in regard to their vascular symptoms and nine had fair or poor results; in the group conservatively treated, one noted improvement and ten were unchanged or worse. Early surgical treatment of these combined syndromes appears warranted.