Aims: To assess morbidity and the long term sequellae following multiple compartment syndrome of the tibia. Methods: We prospectively followed 21 referred patients (pts). Syndromeñs etiology, the socioeconomic consequences and the way the condition affects the quality of patientsñ lives were evaluated. Patientsñ morbidity, the number and the severity of the reconstructive operations were assessed. A subjective SF-36 evaluation was also performed. Results: The aetiology of the syndromes was RTA in 13 pts, accident at work in 7 and in 1 patient the result of an osteotomy and external þxation. Late release of the compartments was performed in 9 pts. In the remaining 2 pts release was performed at onset. The consequences were drop-foot in 14 pts, club foot in 2, cavus foot in 8, clawing of toes in 14, ankle stiffness in 7, plantar numbness and anesthesia in 13, plantar callosities in 5 and chronic infection in 8. Effective management involved 1–10 subsequent reconstructive procedures in the following 1 to 5 years with hospitalization ranging from 35 to 360 days. One patient was amputated. Two pts were able to perform an easy job and only those 2 in whom the compartments were released in time returned to previous occupations. The remaining are currently unemployed. Conclusions: Established compartment syndromeñs effects on soft tissue and bone seriously affect limb function, permanently impair quality of the patientñs life and deprive them from working effectively. These þndings emphasize the importance of early diagnosis and prompt release.