BACKGROUND Soft tissue infections are a common reason for general surgical consultation. Necrotizing soft tissue infections (NSTI) are a rapidly progressive form of this infection that account for significant morbidity and many deaths. METHODS Review of relevant English-language publications. RESULTS There are approximately 500-1,500 cases of NSTI annually in the United States, although accurate estimates of their frequency are difficult to obtain. These infections may be polymicrobial or monomicrobial, and substantial regional heterogeneity exists regarding anatomic location and the involved organisms. Source control with early surgical debridement and targeted anti-microbial therapy are the mainstays of treatment. CONCLUSIONS Necrotizing soft tissue infections remain a common indication for general surgical consultation. Early diagnosis and prompt surgical treatment are essential for effective control.