 Abdominal compartment syndrome, ACS, is a life-threatening condition caused by increased pressure within the abdomen. It can lead to multiple organ failure and death if left untreated. When the pressure inside the abdomen rises above normal levels, it can cause severe damage to the internal organs. This can happen due to a variety of factors, such as trauma or obesity. If the pressure continues to rise, it can become fatal. Symptoms include mental changes, abdominal distension, leg swelling, acute kidney injury, and acidosis. These symptoms may progress rapidly, leading to death from ischemic reperfusion injury and disseminated intravascular coagulation. In this case, early intervention is key to survival. Decompression procedures should be attempted immediately, and preparations must be made for reperfusion injury beforehand. This article was authored by Bayon Hun EOM, Hyun Kim Lim, Nang Tae, and others.