Perforating injury allows the dispersion of environmental fungi and fungal spores together with miniscule foreign bodies into traumatized tissue where they can multiply and cause invasive infection. Acute invasive fungal infection after open fractures is uncommon. The severity of the fungal infections depends on the type of injury (perforating, presence of foreign material), the body area and the general condition of the patient. Fungal infections of the immuncompetent host are generally localized within the dermis, invasion of the fascia, muscles and the bone is rare. Injury-related fungal infections of the immuncompromised host may lead to rapid invasion and generalization of the fungal infection. The following review will focus on the fungal infections after perforating injuries and open fractures including the invasive mycoses as a direct consequence of the trauma, post-traumatic fungal infections, tropical fungal infections (mycetoma), invasive fungal infections after near-drowning and nosocomial invasive fungal infections of the critically ill post-traumatic patient admitted to the intensive care unit.