Carpal tunnel syndrome (CTS) is the most common compressive neuropathy of the upper extremity, with a prevalence of 3% to 10% in the United States. Despite high reported success rates for carpal tunnel release (CTR), symptoms persist or recur in 3% to 20% of patients. The diagnosis of persistent/recurrent CTS should be made based on history and clinical examination findings and supported by confirmatory electrodiagnostic studies. Potential etiologies of persistent CTS include incomplete decompression, secondary site of median nerve compression, irreversible nerve pathology secondary to chronic compression, and inaccurate preoperative diagnosis. Potential etiologies of recurrent CTS include perineural adhesions, reconstitution of the transverse carpal ligament (TCL), and development of secondary causes of median nerve compression. In the setting of revision carpal tunnel release, achieving coverage of the median nerve can sometimes be challenging owing to inadequate vascularized soft tissue. This video shows a cadaveric demonstration of using the hypothenar fat pad to provide additional coverage of the median nerve. This procedure is indicated in the setting of revision CTR when there is inadequate soft-tissue coverage of the median nerve. Once the carpal tunnel has been completely released, the fat pad is mobilized off the TCL and a subcutaneous plane is developed with sharp dissection. Once adequate excursion is achieved with the fat pad, the fat pad is sutured to the radial leaflet of the TCL.