Positional compression syndrome (PCS) is any soft tissue injury consisting of a period of acute ischemia and subsequent reperfusion. A prerequisite for the development of the disease is soft tissue trauma, most often of the extremities, caused by positional compression by body weight. Long-term compression of soft tissues is significantly aggravated by the development of ischemia due to compression of the main and peripheral vessels, and subsequently by the occurrence of ischemic nerve damage. PCS is very rarely diagnosed in a timely manner. This is due to a long-term comatose state, the cause of which the victims hide or do not associate with the development of the disease even when local changes appear. The question of the tactics of treating severe forms of positional compression syndrome remains open. Currently, there is an ongoing discussion about which type of treatment for this injury should be preferred. With timely diagnosis of SPS and immediate initiation of treatment, it is possible to prevent the development or reduce the severity of multiple organ failure and prevent a fatal outcome.