Fifteen percent of adults experience pain in the plantar region and heel at some point in life. One of the causes of this pain is tarsal tunnel syndrome (TTS). In this video, we provide a detailed explanation of an ultrasound-guided technique for release of proximal and distal TTS. Using three-dimensional videos, innovative diagnostic tests, and the results of our research, we show the application of our surgical technique both in cadavers and in patients. The prevalence of TTS reported in the literature is lower than that of other compressive neuropathies. Many patients who have been treated for plantar fasciitis with no definitive diagnosis do not improve despite multiple treatments. Most have undiagnosed TTS, which can be considered a hidden, silent epidemic. TTS is a type of compression neuropathy that results from entrapment of the tibial nerve and its branches. Proximal TTS is entrapment of the tibial nerve behind the medial malleolus by the laciniate ligament or flexor retinaculum. Distal TTS is entrapment of the medial and lateral plantar nerves and first calcaneal branch beneath the deep fascia of the abductor hallucis muscle. There are two distal tunnels, one for the medial plantar nerve and another for the lateral plantar nerve. Compression of the tibial nerve and its branches may be caused by extrinsic or intrinsic factors. In 20% to 40% of patients, the syndrome is considered idiopathic, a mixture of mechanical, vascular, and metabolic causes. The diagnosis of TTS is based on clinical history, physical examination findings, and imaging test results. Innovative ultrasound-guided tools may help to identify higher pressures in the proximal and distal compartments. Values higher than 33 mm Hg in the proximal tarsal tunnel, 50 mm Hg in the lateral plantar tunnel, and 56 mm Hg in the medial plantar tunnel are considered abnormal and therefore positive for TTS. The reliability of electroneurography increases considerably when the position of the needle is guided by ultrasound. It confirms the diagnosis and indication for surgery and could become a keystone of diagnosis in future years. An ultrasound-guided suppression test or nerve block requires the injection of 0.5 cc of lidocaine around the tibial nerve. Significant pain relief is considered a good predictor of neuropathy. A typical clinical picture, positive Tinel and Valleix signs, and a positive anesthetic suppression test result (or a positive result on an additional test, when available) are sufficient to establish the diagnosis and the indication for surgery. Surgical procedures currently include open surgery, endoscopic surgery, and ultrasound-guided ultra-minimally invasive surgery. The results of ultrasound-guided release are excellent and similar to those of open surgery. Ultrasound-guided release of the proximal and distal tarsal tunnel is a novel procedure that reduces the frequency of complications, because it is performed without a tourniquet. It can be performed as an outpatient procedure, with 1- to 2-mm incisions and local anesthetic, and enables surgery in patients with vascular problems or diabetes because wound healing is not a concern. Our approach can be combined with other ultrasound-guided techniques, such as gastrocnemius lengthening, for the treatment of TTS with minimal complications. The technique is limited by its learning curve and the fact that it is not indicated for intrinsic causes of TTS.