Compartment syndrome is an abnormal pain condition that occurs when pressure within the muscles builds to dangerous levels, causing blood flow decrease, which prevent nourishment and oxygen from reaching nerve and muscle cell of the limb.Pain is made worse by passive stretching of the muscle involved and there is an associated sensory disturbance. The prognosis is directly related to the speed at which the diagnosis is made and treatment begun. Case presentation: Case report. A 38-year-old woman, presented after car accident with closed fracture of the left tibial shaft (42-A2.2 according AO classification), Muller et al 1990 [2] and bruises at her right forearm and thigh but no bone fractures was revealed at the radiology examination. Before operation there were no apparent signs of neurovascular compromise. The fracture was initially stabilized in a plaster back slab and closed, ORIF locking plat then was performed. Based on our patient case, the delay in diagnosis was critical. When there is a possibility of a compartment syndrome, we physician should be cautious when using local anesthesia or pain relieved medication, in case of patient report of altered sensation in her foot and her leg, intracompartmental pressure measurement should be performed immediately