The gluteal region is not commonly thought of as a compartment, yet nondistensible osseofascial boundaries do exist. As with any case of compartment syndrome expedient therapeutic measures are critical to salvaging neuromuscular function. The gluteal compartment is unique, however, because of its tremendous muscle mass and great potential for producing devastating systemic sequelae. Gluteal compartment syndrome is most commonly associated with unconscious patients who are recumbent for prolonged periods, but trauma, spontaneous bleeding, and overexertion can also cause it. We present a case report of gluteal compartment syndrome after bone marrow biopsy of the iliac crest. Recognizing gluteal compartment syndrome as an entity and maintaining a high index of suspicion for its development especially in unconscious patients can avert disaster regardless of etiology.