Abstract—Background: Fat embolism is the most frequent cause of death after fracture of long bones. Fat embolism were first described by Zenker (1862). The most common clinical situation in which Fat Embolism Syndrome (FES) may develop is orthopedic or general trauma. The purpose of this study was to review the FES experiences in a tertiary referral center between May 2005 and May 2007. Methods: Over 2 years period, 210 patients with single long bone fracture of lower limb (femur or tibia) admitted to our tertiary care centre were prospectively evaluated. FES was diagnosed clinically among those patients showing one or more signs of Lindeque¡¯s criteria. Results: among 210 patients, 4.76% developed clinical FES. The incidence of fat embolism in patients with fracture femur was significantly higher (p = 3.63 X 10 -18 ) than that with tibia. Majority of patients belong to age group of 25-34 years, 3 presented with petechiae, 11 with thrombocytopenia. Statistically significant association found between FES with PaO₂ less than 60 mmHg as well as more time taken to admit patient to hospital after injury. Conclusion: The incidence of clinical FES is seen more with femur fracture and delay admission to hospital. As it is tertiary and trauma care centre, many patients had road traffic accidents.