A case of Acute Post Exertional Anterior Compartment Syndrome of the leg, seen five days after the onset of symptoms is presented. Decompression with delayed closure was done. There was only sensory recovery. However functional recovery at one year was good. Acute Post Exertional Compartment Syndrome cases are diagnosed late due to the lack of awareness, the paucity of radiological features, and the presence of intact peripheral pulses. A review of the literature revealed no previous documentation from South-East Asia.