Objective To analyze the characteristics of nerve conduction in patients with amyotrophic lateral sclerosis (ALS) and to investigate the correlation between nerve conduction and different sites of onset.Methods Analysis was performed on 47 cases who were outpatients or inpatients with ALS in our hospital from January 2012 to December 2014 and 40 healthy controls who had been physically examined. Motor and sensory nerve conduction and F-wave were determined for the participants.Results The patients with ALS showed increased distal motor latency, reduced compound muscle action potential (CMAP) amplitude, and decreased motor conduction velocity, among which CMAP amplitude reduction was the main manifestation. The "split hand" and "split foot" phenomena were observed. It was revealed by clinical manifestations, physical signs, or electrophysiological examinations that sensory nerve conduction was involved in some of the patients. The rate of F-wave appearance was abnormal in some patients.Conclusions The diagnosis of ALS is based on comprehensive analysis of clinical and neuroelectrophysiological examination results and cannot be hastily excluded by only one result among the methods. Clinicians, especially those from primary hospitals, must thoughtfully and carefully evaluate the results of accessory examinations to reduce missed diagnosis and misdiagnosis.