This chapter explores the medical legal aspects of compartment syndrome. As one of the major orthopedic emergencies, acute compartment syndrome carries significant risks when the diagnosis is delayed or missed. The consequences for both the patient and the treating orthopedic team are severe and should be examined closely. Orthopedic surgery is one of the most commonly sued medical specialties, and the indemnity payments in acute compartment syndrome cases are some of the highest medical malpractice claims. We will discuss the relationship between orthopedic surgery and malpractice, acute compartment syndrome, and litigation, factors that contribute to indemnity payments, as well as the way to avoid missing compartment syndrome and malpractice claims.