A review of the literature yields few reported cases of industrial-strength high-pressure water injection injuries involving the foot, and sources of information for industrial-strength high-pressure water injection injuries reside primarily in the hand surgical literature. Toxic materials, such as grease, paint, and diesel oil, are relatively common agents involved in injection injuries, and these substances are associated with increased morbidity in comparison with injection of water or air. Treatment of high-pressure injection of a toxic substance is a surgical emergency requiring irrigation, debridement, antibiotic administration, and monitoring for signs and symptoms of compartment syndrome. There are, however, documented cases where less extreme treatment regimens have met with success. We report a successful limb salvage case, and review of the literature, related to a high-pressure water injury involving the foot with associated extensive subcutaneous emphysema.