Acromegaly is a rare endocrine disorder often diagnosed late, with carpal tunnel syndrome (CTS) being a common musculoskeletal presentation. A previous study in another Nigerian region reported a high prevalence of acromegaly among patients with CTS. This study aimed to replicate those findings in the orthopaedic clinic setting of Ibadan, Nigeria. The primary purpose was to investigate the prevalence of acromegaly and its diagnostic delay among patients presenting with CTS at orthopaedic clinics in Ibadan. Specific objectives were to determine the proportion of acromegaly in this cohort and to quantify the average delay from symptom onset to definitive diagnosis. A cross-sectional study was conducted at two major orthopaedic clinics. Consecutive adult patients diagnosed with CTS were screened for clinical features of acromegaly. Suspected cases underwent confirmatory biochemical evaluation, including IGF-1 measurement and, where indicated, an oral glucose tolerance test with growth hormone measurement. Diagnostic delay was calculated from patient-reported symptom onset. No confirmed cases of acromegaly were identified among the 127 patients with carpal tunnel syndrome who completed the study. The measured prevalence was therefore 0%. An analysis of diagnostic delay for acromegaly was not applicable within this cohort. This replication study found no evidence of acromegaly among patients presenting with carpal tunnel syndrome at orthopaedic clinics in Ibadan. This contrasts with the findings of the earlier study, suggesting significant geographical or clinical population heterogeneity within Nigeria. Routine screening for acromegaly in all patients with carpal tunnel syndrome in this specific clinical setting may not be justified. Further multi-centre studies are required to clarify the association and to identify any high-risk subgroups where targeted screening would be clinically and cost-effective. Acromegaly, carpal tunnel syndrome, prevalence, diagnostic delay, replication study, Nigeria. This study provides a necessary replication of prior research in a different clinical context, highlighting the variability of acromegaly prevalence and questioning the uniformity of screening recommendations across Nigerian orthopaedic settings.