Resuscitation and the development of abdominal compartment syndrome (ACS) are closely associated and frequently overlapping critical care topics. Elevated intra-abdominal pressure (IAP) can cause major deterioration of cardiac function by affecting preload, contractility, and afterload. Pathologically elevated IAPs are often compounded by the presence of shock leading to imminent organ failure. Excessive or overzealous resuscitation in an attempt to restore perfusion and correct these organ dysfunctions and failures can worsen elevated IAP and increase the risk of ACS. The aim of this review is to discuss these multilevel interactions between resuscitation and ACS identifying appropriate resuscitative strategies for the patient with elevated IAP.