This chapter offers a detailed overview of the acute management of circumferential deep-partial-thickness and full-thickness burns, including indications for emergent escharotomy, escharotomy technique, and common complications. Common history and physical findings, diagnostics, and differential diagnoses relevant to burn eschar are reviewed. Also detailed are indications for decompressive surgical therapy in burn patients independent of circumferential burns, common curveballs encountered on the oral boards, and “clean kill” scenarios pertinent to the oral boards.