Decompression illness (DCI) is the manifestation of clinical symptoms due to formation of free phase gas (bubbles) as sequelae of suddenly reduced ambient pressure on the dissolved inert gases in the various body tissues. It is seen in the settings of diving, aviation, and space exploration. In diving, DCI is most commonly encountered in those dives which are excessively long or deep or in whom the mandatory ‘stops’, which are halts during ascent to surface to harmlessly remove the dissolved inert gas in the various body tissues, have been omitted. In saturation diving, meticulous steps in the form of a prolonged monitored decompression in the controlled environment of a decompression chamber are taken to obviate DCI.1 This is further reinforced by providing a high fraction of inspired oxygen (FiO2) to decrease the inert gas uptake as well as to enhance the removal of the dissolved inert gas harmlessly. Hence, occurrence of DCI during saturation diving, reflects either poor dive execution or an idiosyncratic phenomenon.2,3 We present a case of musculoskeletal decompression illness (Type I) after saturation diving, which is reflective of the idiosyncratic nature of the illness and has implications for the employability restrictions for the individual. This case also highlights the limitations of completely preventing it even by meticulous execution of the dive.