Exertional compartment syndrome is most commonly described in its chronic form in the young sportive patient. The acute form is a lot rarer and usually only unilateral. We report a case in which a chronic compartment syndrome became acute after intense effort. This was diagnosed rather late due to the lack of knowledge about this syndrome. The necrosis noticed during the fasciotomy was removed by iterative interventions. The wound was left in secondary healing because the patient refused a flap. Upon the patient's last follow-up visit, the wound was healed, but he had a complete deficit in dorsal flexion of the ankle, a foot drop and consequently a step-page gait.