Acute gluteal compartment syndrome (AGCS) is a rare condition associated with trauma, drug abuse, alcohol intoxication, prolonged immobilization, hip arthroplasty and epidural anesthesia. We report the case of a 42-yearold woman presenting severe buttock pain following decreased lower extremity motor function after an incident whereby she rolled down a flight of stairs. We performed fasciotomy of the gluteal fascia in order to provide relief from acute gluteal compartment syndrome. At the 2 month follow up visit her sensory and motor function had improved. Acute gluteal compartment syndrome is a rare condition which can result in misdiagnosis or delayed diagnosis. Careful consideration is needed for patients suffering severe buttock pain.