Fat embolism syndrome is a condition of acute respiratory distress following long-bone trauma. This condition may involve not only the lungs but also a number of other body systems. The pathophysiology is not as yet clearly understood, however, intravasation of fat from long-bone fractures may play a role. Early recognition of the severity of injury both on clinical and biochemical grounds and early surgical stabilization of long bones may help to decrease its incidence. However, the best surgical technique with which to do this stabilization has not yet been clearly determined. Surgical and pharmacological techniques have been developed in an attempt to either decrease the intravasation of fat during long-bone stabilization or block the inflammatory cascade with varying degrees of efficacy. Ongoing research focuses on both the prevention and treatment of this condition.