Necrotizing soft tissue infections represent a surgical emergency and require immediate clinical attention. Most cases of necrotizing soft tissue infections are the result of damaged host defences, be it anatomical barriers or some underlying immune deficiency. They are characterized by the absence of clear local boundaries or palpable limits between necrotic tissue and surrounding viable tissue. Any delay in surgical treatment can profoundly affect the prognosis. Important clinical interventions besides surgery are wide-spectrum antibiotics and symptomatic support. Radical debridement of necrotic tissue and pus is a fundamental surgical principle for the treatment of necrotizing soft tissue infections. Final reconstruction of soft tissue cover is often challenging due to the mutilating nature of surgical debridement.