Compartment syndrome, if not identified and acted upon early, will result in irreversible damage to neuromuscular soft tissues. Therefore, orthopaedic nurses must be aware of the risks, signs and symptoms, unusual circumstances, and appropriate medical and nursing interventions with this syndrome. Usually compartment syndrome is considered to occur with fractures of the tibia, the forearm, or in vascular injuries or burns where there is significant edema. Not as common are compartment syndromes that occur after intramedullary nailing, in the thigh or upper arm, or in the presence of fracture blisters. These unexpected compartment syndromes each occurred only once in the author's many years as an orthopaedic clinical nurse specialist at a major trauma center. However, in each case, the situation and actions were significant. Compartment syndrome will be reviewed with supporting current literature. Each scenario will then be analyzed in terms of the particular considerations surrounding the diagnosis, treatment and nursing implications with the compartment syndrome.