There is a paucity of literature on compartment pressure thresholds and complications following fasciotomy in postoperative Total Knee Arthroplasty (TKA) patients. The purpose of this study is to identify the postoperative course in a series of patients who had surgical decompression following TKA. We identified six patients who underwent fasciotomy for proven or suspected compartment syndrome following primary TKA between 2000 and 2010. The etiology of compartment syndrome was indirect (5 cases) vascular injury and one unknown. Complications after fasciotomy were: periprosthetic infection (2), foot drop (2), fasciitis (1), cellulitis (1), above the knee amputation due to periprosthetic infection (1). Currently, it is unknown if the same principles in the trauma patient apply for both diagnosis and treatment of compartment syndrome after TKA. We conclude that surgeons need to maintain a relatively higher threshold for performing a fasciotomy following TKA.