The anterior tibial compartment syndrome represents a surgical emergency. The degree of functional recovery is inversely proportional to the time taken to surgically decompress the anterior compartment. Since the surgical procedure is completed within minutes, the time taken to make the diagnosis of the anterior tibial compartment syndrome is vital. Once that diagnosis is made, surgical release must be done without delay. In this paper the authors make a plea for early recognition and treatment of this condition and attempt to point out the signs and symptoms which are diagnostic of the anterior tibial compartment syndrome. This syndrome is represented in the literature by two distinct groups of cases.2,9,13,14, 16,20 In group one there is a demonstrable arterial or osseous lesion which accounts for the symptomatology. In group two, the syndrome is caused by severe or unaccustomed exertion involving the lower extremities, and there is no proven anatomical lesion