Introduction Eosinophilic fasciitis is a rare variant of scleroderma involving the subcutis and fascia of the skin, characterised by fascial thickening. It usually affects adults aged 20-60 years old, more often males in a 1:2 ratio. Eosinophilic fasciitis is the result of an autoimmune mechanism targeting damaged fascia causing fibrosis. Treatment often involves systemic immunomodulating medications or corticosteroids to control or slow the disease process. Methods + Discussion: We present a case report of treatment resistant systemic morphea requiring surgical management to release fibrotic fascia. A 56-year-old male was initially referred to the Plastic Surgery department for biopsies of the deep fascia for histological confirmation of disease process. Following disease progression despite medical management, with symptoms of chronic compartment syndrome, surgical fasciotomy for decompression was offered. Staged compartment releases of the forearm and lower limbs were successfully completed with significant improvement in patient symptoms and objective range of movement measurements by physiotherapist and occupational therapists. Operative management continued as disease progression to the ankle joint resulting in reduced dorsi and plantar flexion. Staged anterior ankle releases and skin grafting, utilising fundamental principles of scar release to improve patient quality of life. Conclusion: Surgical management of eosinophilic fasciitis is usually reserved for joint contracture, mostly in the upper limb where it involves the digits and wrist requiring release. This case highlights the role of surgical intervention with fasciectomy to effectively alleviate symptoms and allow the patient to resume activities of daily living