Neurological symptoms after decompression from a dive are usually thought to be manifestations of central nervous system (CNS) decompression sickness (DCS). We present a case of DCS in which neurological symptoms are present but which the clinical findings, magnetic resonance imaging and electroneuromyographic studies suggest were caused by muscle injury and exacerbation of an existing peripheral neuropathy. This finding supports the alternative hypothesis that some neurological symptoms and signs in DCS are due to effects on peripheral nerves rather than the CNS.