This report is the first account of Guyon's syndrome after the bilateral use of forearm crutches. Crutch palsy is usually neuropraxic in nature and associated with clinical and electrophysiologic recovery of nerve function, especially if patients are instructed to not bear excessive weight on the wrist. The present case history follows this pattern. In establishing the diagnosis of a focal compression neuropathy, a combination of clinical assessment and neurophysiologic studies are typically used. This report describes the additional application of ultrasound imaging to verify the diagnosis and to track changes in the appearance of the nerve during follow-up.