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Acute lumbar paraspinal compartment syndrome (APCS) is rare. This case report describes the clinical presentation and magnetic resonance imaging (MRI) findings of APCS in a young man after strenuous weight training. The patient underwent surgical decompression of the paraspinal muscles with fasciotomy 4 days after presentation and made a complete functional recovery at the 3-month follow-up postsurgery. This case report highlights the importance of MRI in facilitating the diagnosis of APCS and demonstrates that fasciotomy, ev