Compartment syndrome and crush syndrome are two separate clinical pictures. Crush syndrome results following a higher energy injury which lasts for a longer period of time compared to compartment syndrome. Understanding the physiopathology will facilitate correct therapeutic approaches. It is very important to protect the kidney from toxic metabolites that enter the circulation from the crushed extremity in crush syndrome and to provide supportive treatments quickly for survival. Unfortunately, the number of references in the literature regarding which patients should be treated surgically, how and when, and with which technique, is very limited. In the treatment of compartment syndrome, fasciotomy performed in the early period may be effective in protecting the extremity and life, while the indication for fasciotomy in delayed compartment syndrome is very limited. Likewise, the use of fasciotomy in the treatment of crush syndrome is controversial. Fasciatomy can be performed in patients who can be intervened in the early period and the debris is not too severe, but performing a fasciotomy in the late period is very controversial, just like in compartment syndrome. Debridement and amputation of large necrotic muscle tissues can sometimes be life-saving in crush syndrome.