Abstract: Objective To study the efficacy of micro-invasive decompression of posterior tibial nerves in treating tarsal tunnel syndrome. Methods Ninety-two patients with tarsal tunnel syndrome received micro-invasive decompression of posterior tibial nerves. All these patients had either their physical examination findings or nerve conduction studies proved to be consistent with tarsal tunnel syndrome. Results The symptoms of numbness and pain in all patients were relieved immediately after operation. Complications included only one delayed wound healing. Conclusions Micro-invasive decompression of posterior tibial nerves is an effective and safe method for the treatment of tarsal tunnel syndrome. Patients demonstrate a high return- to-work rate and an extremely low complication rate.