Background: Rheumatoid arthritis (RA) is an inflammatory, long-term systemic autoimmune disease with extra-articular manifestations(EAMs). One of the most common EAMs associated with rheumatoid arthritis is median nerve entrapment at wrist (Carpal Tunnel Syndrome), occurring in about 30% of rheumatoid arthritis patients. Aims: This study aimed to determine the prevalence of Carpal Tunnel Syndrome among rheumatoid arthritis patients in Basrah, south of Iraq, and to assess its clinical and electrophysiological changes. Methods: A cross-sectional study was carried out in Basrah governorate, south of Iraq on patients with confirmed diagnosis of rheumatoid arthritis. Their clinical, and electrophysiological characteristics using nerve conduction studies were documented. Results: Out of 110 individuals with rheumatoid arthritis, 44 (40%) were diagnosed with carpal tunnel syndrome. The CTS and non-CTS groups exhibited no significant differences in age, sex, BMI, RA duration, disease activity, treatment, or laboratory parameters (all P>0.05), however, smoking was much more common among CTS patients (P=0.003). Bilateral involvement was predominant (72.7%). Nerve conduction examinations revealed markedly prolonged median motor and sensory latencies, diminished conduction velocities, and decreased sensory amplitudes in patients with CTS (all P