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High saphenous vein ligation (HSVL) with stripping and multiple stab avulsion (MSA) is usually a simple and straightforward technique used to treat the varicose vein. Recurrence, infection, hematoma, sural nerve injury are commonly seen complications. Here we report a rare presentation of compartment syndrome after HSVL and MSA. The diagnosis was a challenge initially as compartment syndrome following such procedure is extremely rare and have not been reported much. The patient was subsequently treated surgically with a four-compartment fasciotomy and recovered with partial foot drop. Regardless of its cause, compartment syndrome required prompt surgical treatment and a delay of more than 6 hours can lead to irreversible myoneural damage.