We surveyed military orthopedic surgeons to investigate the clinical practice of performing invasive compartment pressure (ICP) testing in patients with suspected chronic exertional compartment syndrome (CECS).Eighty-five percent of respondents agreed or strongly agreed with always confirming the diagnosis of CECS with ICP testing. Thirty-nine percent stated they would recommend surgical treatment without ICP testing if they were confident about the diagnosis based on clinical examination findings. Survey results highlighted differences between surgeons with more and less experience in evaluating patients with suspected CECS. Respondents who were in practice longer and respondents who saw more patients with suspected CECS per year were more likely to recommend surgical treatment based on clinical diagnosis alone. Diagnosis of CECS is challenging, and diagnostic modalities remain imperfect. There is less than 100% agreement about use of ICP testing, which is the gold standard for diagnosis. While most survey respondents agreed that ICP testing should be used in the diagnosis of CECS, clinical acumen and experience seem to significantly influence actual use.