The history, clinical findings, and treatment of the acute and chronic anterior tibial compartment syndromes have been presented. The diagnosis in the chronic syndrome is suggested by a history of pain in the anterior tibial compartment coming on only after strenuous exercise of the lower extremity and completely relieved by rest. In patients with symptoms characteristic of the chronic form of this syndrome the acute form of the anterior compartment syndrome may develop. Emergency fasciotomy should be done in patients with the acute anterior tibial compartment syndrome. In the chronic syndrome, fasciotomy may be indicated in those patients who do not desire or are unable to curtail their activities sufficiently to alleviate symptoms. Thirteen patients with the acute anterior tibial compartment syndrome and five with the chronic syndrome have been seen and illustrative case histories are presented.