This video demonstrates surgical release of the first extensor compartment for De Quervain’s tenosynovitis. Performed under local anesthesia with tourniquet control, the procedure involves a zigzag incision over the radial styloid, careful dissection to preserve sensory nerve branches, and release of the thickened retinaculum. Attention is given to identifying multiple tendon slips and accessory compartments. Following confirmation of free tendon excursion and hemostasis, the wound is closed with non-absorbable sutures. Patients typically experience rapid recovery with excellent symptomatic relief.