Abstract Background: Acute compartment syndrome of the leg may be a devastating complication of a tibial fracture. Metic-ulous and repeated examinations of the patient who has such a fracture are needed to ensure the diagnosis of acute com-partment syndrome (ACS). A.C.S. remains challenging in many patients although the "5 Ps" of compartment syndrome; pain, pallor, paralysis, pulselessness, and paresthesia. Aim of Study: To measure intra-compartmental pressure in different compartments in the lower leg in tibial fractures and to correlate it with common clinical findings found in acute compartment syndrome in trial to early detect acute compartment syndrome and to decrease its devastating com-plications and rate of fasciotomy. Patients and Methods: This study was conducted on 100 patients referred to the Emergency department having Tibial fracture predisposed to have acute compartment syndrome by measuring intra-compartmental pressure instrumentally using stryker intra-compartmental pressure monitoring system and correlated with clinical picture and detect the percentage of patients need fasciotomy. Results: The Stryker intra compartmental monitoring system (STIC catheter) has accuracy and easy to measure intra-compartmental pressure and helps us to early detect A.C.S. in the lower leg also to decrease rate of fasciotomy and complications but it is expensive and needs proper training to use it. Conclusion: The patient who undergoes fasciotomy re-quires a physical therapy program to regain function. Postop-erative care and rehabilitation are just as important as the procedure itself.