A case of acute compartment syndrome of the forefoot after revisional arthroplasty of the forefoot is presented. Shortening of the compartments due to bony resection and extensive dissection due to previous scarring may have predisposed to the pathological condition. Prompt decompression based on clinical grounds prevented any long term sequelae. Allowance must be made for the concomitant use of local anaesthetic procedures which may obscure the clinical picture.