The purpose of this study is to evaluate the documentation of acute compartment syndrome (ACS) in combat casualties in an effort to identify potential areas for improvement. Medical records of U.S. service members wounded during the current conflicts in Afghanistan and Iraq who underwent fasciotomies were reviewed. Key descriptors including signs and symptoms of ACS were recorded. Injury severity scores and muscle excision at the time of fasciotomy were also included for analysis. Of 134 patients who met inclusion criteria, documentation was inadequate overall in 65 patients (49%). Fourteen (10%) had muscle excised at the time of fasciotomy, but this was not associated with a higher rate of inadequate documentation. This study demonstrates the need for improved awareness and documentation of impending compartment syndrome in the austere setting to improve the continuity of care during the medical evacuation process.