This study evaluates the mid-term outcomes of arthroscopic release for refractory lateral epicondylitis (tennis elbow) in 22 patients over a mean follow-up of about 5 years. Patients experienced significant improvements in hand-grip strength, reaching 96.4% of their uninvolved side, and reported substantial pain relief, with VAS scores dropping from 7.86 to 0.79. Strength was notably restored within the first month postoperatively and continued to improve up to 6 months, stabilizing thereafter. The procedure effectively allowed patients engaged in heavy manual work to resume their activities without limitations. The surgical technique also enables detection and treatment of intra-articular pathologies that might hinder recovery. The study emphasizes minimally invasive arthroscopic release as a successful option for chronic resistant cases. Limitations include lack of a control group and the need for experienced surgeons. Overall, patients showed excellent functional recovery and return to work within a few months. Further research is needed to understand the long-term healing process after this surgery.