Necrotizing fasciitis is a severe, rapidly progressing infection of the subcutaneous soft tissues extending into the fascia. Etiology can include direct inoculation or contiguous spread related to trauma, surgery, decubitus wounds, or abscesses. Subtypes of necrotizing fasciitis include polymicrobial (type I), group A streptococcal (type II), clostridial (type III), and fungal (type IV). The earliest findings may include pain, erythema, increased warmth, swelling, and lymphangitis. Later signs may consist of large bullae, cutaneous necrosis, and subcutaneous gas along with symptoms of systemic toxicity. These patients need prompt administration of broad-spectrum antibiotics and emergent surgical debridement.