We report a case of fulminant fat embolism syndrome treated with high frequency oscillatory ventilation (HFOV). A 77-year-old woman sustained a right tibia and fibula fracture and a left open tibia fracture after a traffic accident. She was conscious and her respiratory condition was normal on admission. However, she suddenly progressed to a coma and was intubated for approximately 2 hours after the accident; she developed critical respiratory failure. We used HFOV and were able to maintain her respiratory status. However, her right heart failure deteriorated and she died 95 hours after the accident. It was difficult for her to survive without percutaneous cardiopulmonary support.