From antiquity to today, tissue repair and wound healing have played a central role in health. Over the past generation, negative pressure wound therapy (NPWT) has shown itself to be a valuable adjunct in wound healing, with effects that are superior to many traditional wound treatment modalities. Applications of NPWT are widespread, with use seen in management of severe soft tissue loss, prevention of surgical site infections, treatment of diabetic foot ulcers, and improving skin graft survival. This article reviews the biology, mechanics, and therapeutic effects of NPWT, while also discussing social and economic aspects of use. Finally, various possible adjustments and modifications to NPWT are addressed, all of which contribute to the continual evolution of NPWT at the frontier of modern wound healing and surgery. How to cite this article Hatch DC, Sauciuc V, Wagler EC, Schenavar B, Armstrong D. Negative Pressure Wound Therapy: Past, Present, and Future. J Foot Ankle Surg (Asia-Pacific) 2016;3(2):80-87.