Compartment syndrome occurs when the pressure within a closed anatomic space (a compartment) becomes so elevated that capillary perfusion is compromised and tissue ischemia develops. Compartment syndromes are classically a complication associated with orthopedic trauma, occurring when muscular compartments of extremities develop elevated pressures requiring decompressive fasciotomies. However, any closed anatomic space, including the abdominal cavity, is at risk of developing a compartment syndrome. Abdominal compartment syndrome is a clinical disease spectrum that results from elevated intra-abdominal pressure (IAP) due to tissue edema or free fluid collecting in the abdominal cavity. Elevated pressure in the abdomen is referred to as intra-abdominal hypertension (IAH) while the end stage organ failure that occurs due to the pathophysiologic derangements that occur as a result of increasing intra-abdominal pressure is referred to as the abdominal compartment syndrome (ACS). This clinical spectrum dramatically impacts patient outcome: The end result of undetected and untreated intra-abdominal hypertension is multisystem organ failure and patient death.