BACKGROUND: Chronic exertional compartment syndrome is an entity that typically fails nonoperative management and requires operative treatment with fasciotomies for return to activity. Fasciotomies performed through single or multiple incisions may fail to totally release the fascia of the afflicted compartment(s) and may result in injury to neurovascular structures that cannot be visualized. PURPOSE: The authors report results of endoscopic compartment release with the assistance of a balloon dissector in the treatment of chronic exertional compartment syndrome. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: The clinical outcomes of 14 cases of chronic exertional compartment syndrome in 9 patients treated with endoscopic release were assessed with a retrospective chart review and the results of mailed questionnaires. RESULTS: Fourteen legs in 9 patients (4 male and 5 female; average age, 24 years) were treated with endoscopic compartment release for chronic exertional compartment syndrome. Eight of 9 patients were able to resume preoperative activities, including collegiate athletics in 5 cases and recreational sport in 3 cases. No neurovascular injuries occurred. Complications were isolated to postoperative hematomas that resolved in 2 patients. Seven patients completed questionnaires an average of 3.75 years after surgery. There were no recurrences of symptoms. CONCLUSION: Endoscopic compartment release is a cosmetic, safe, and effective means of treating chronic exertional compartment syndrome.