Incidence of Fat embolism syndrome (FES) in fractures is about 16.3 but sometimes it is as high as 50% to 62%. The fat embolism is common in fatty bed ridden patients and in whom reamed interlocking is performed under tourniquet with prolonged injury-surgery interval. However in the case discussed here FES occurred under the exact opposite circumstances. In this 23 year lean and thin female with closed tibia fracture unreamed interlocking was performed without tourniquet & the operative procedure was done within 4 hours after trauma. Her pre-operative investigation were within normal limit. We want to discuss by this case report to highlight that even when risk factors are absent outlier events of FES can occur in any case and symptoms should not be discounted.