Ulnar nerve entrapment at the elbow is an important and relatively frequent pathological condition that may be related to different causes depending on individual or external factors. The cause of the nerve lesion is also idiopathic in about one-quarter to one-third of cases. This variable aetiopathogenetic presentation has often suggested different diagnostic and clinical approaches and, moreover, various surgical procedures. We present our 8-years surgical experience with 290 cases of ulnar nerve entrapment at the elbow analysing the salient clinical features and the results of the surgical treatment in the light of the relevant literature available on this topic.