Purpose <p>Acute compartment syndrome (ACS) is a severe complication associated with tibial fractures, which can result in irreversible muscle and nerve damage if not promptly identified and treated.</p> Method <p>This study systematically searched PubMed, EMBASE, the Cochrane Library, and Web of Science. Data on demographics, fracture attributes, injury mechanisms, and biomarkers were extracted. Meta-analyses were performed using both fixed- and random-effects models, depending on the degree of heterogeneity.</p> Result <p>A total of 17 studies were included. Younger adult age and older age in pediatric populations were both linked to higher ACS risk, depending on the age group. ale sex was strongly associated with ACS. High-energy traumaand polytrauma were also associated with a heightened risk. Delayed external fixation also showed a protective effect, albeit based on limited evidence. Biomarkers, including elevated monocyte count and creatine kinase-MB levels, were also significant predictors.</p> Conclusion <p>Younger adult age, male sex, high-energy trauma, and polytrauma were identified as critical risk factors for ACS in tibial fractures. Findings emphasize the need for standardized definitions and prospective investigations. Further research addressing pediatric age ranges, fracture location, and biomarker validation is essential to refine risk assessment and optimize early interventions.</p>