Acute compartment syndrome (ACS) is a limb-threatening condition caused by increased pressure that compromises blood flow within fascial compartments of the affected limb. The appropriate management in almost all cases is emergent surgical intervention for fascial release to decrease compartment pressures. In most clinical situations, the diagnosis of ACS relies upon clinical examination, although intracompartmental pressure measurements are used as an adjunct in select situations. The primary goal of operative management is complete decompression of all involved compartments in a timely manner. The primary goal of postoperative management is to safely obtain durable wound coverage. Missed compartment syndrome can result in significant morbidity for patients.