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Background: Gluteal compartment syndrome is a very rare condition characterized by non-specific symptoms that often lead to misdiagnosis. Case presentation: We report a case of gluteal compartment syndrome in a 38 year-old Caucasian male (intravenous drug user) following prolonged immobilization due to loss of consciousness. The delay in the appropriate diagnosis and treatment led to a temporary acute kidney injury and to irreversible sciatic nerve palsy. Conclusion: Delay in the definitive diagnosis and treatment of gluteal compartment syndrome, may lead to higher morbidity of the affected extremity and in rare cases even patient mortality. Special emphasis is given to the aetiology, symptomatology, differential diagnosis as well as the treatment of this condition. [ABSTRACT FROM AUTHOR]