Diagnostic radiology is essential for providing targeted management of different diseases. Thus, there has been a dramatic increase in the demand for medical imaging. However, acute compartment syndrome (ACS) is one of the clinical scenarios in which radiology has limited value. The authors report a nontraumatic spontaneous ACS in the forearm of a 56-year-old female. The roles of Ultrasound and MRI, if available, are also illustrated. Limited reports of spontaneous ACS are published in the literature; we hope this case adds to the limited data. Our goal in reporting this case is to improve clinical practice with favorable outcomes for the patients involved globally by alert to the onset of ACS to promote early detection and timely fasciotomy. Also, we aim to increase awareness among physicians and radiologists of the limitations of radiology in specific clinical scenarios. Finally, it may aid in illuminating a possible link between malignant hypertension, spontaneous bleeding/hematoma, and ACS.