Rationale:Necrotizing fasciitis is a destructive tissue infection with rapid progression and high mortality. Thus, it is necessary that high-performance dressings be introduced as possibilities of treatment.Patient concerns:Female patient, 44 years of age, admitted to hospital unit complaining of lesion in the gluteal region and drainage of purulent secretion in large quantity followed by necrosis.Diagnoses:The diagnosis of necrotizing fasciitis was carried out with the computerized tomography examination result and its association with the patient's clinical condition.Interventions:Initially, successive debridements were carried out in lower limbs as well as primary dressing with enzymatic debriding action until indication of negative pressure wound therapy, for the period of 2 weeks in the right lower limb and for 5 weeks in the left lower limb, with changes every 72 h. Dressing with saline gauze was used at the end of this therapy until hospital discharge.Outcomes:After the use of negative pressure wound therapy, we observed the presence of granulation tissue, superficialization and reduction of lesion extension. The patient presented good tolerance and absence of complications.Lessons:Negative pressure wound therapy constituted a good option for the treatment of necrotizing fasciitis, despite the scarcity of protocols published on the subject.