Lateral epicondylitis is one of the most common causes of elbow pain and has been known to be caused by degeneration of the extensor carpi radialis brevis (ECRB). Nonoperative treatment should be tried first in all patients, because it has been deemed highly successful; however only few prospective studies suggest that symptoms frequently was completely resolved. Operative treatment is indicated for recalcitrant pain after failed conservative treatment, which involves excision of the pathologic portion of the ECRB and results in a high degree of subjective relief and functional restoration. We will review the pathology of the lateral epicondylitis and operative and nonoperative treatment of lateral epicondylitis.