Necrotizing fasciitis (NF) is a deadly soft tissue infection characterized by necrosis of subcutaneous tissues. In this study, our aim was to identify variables affecting patient outcome and mortality in necrotizing fasciitis and their temporal changes. We reviewed records of 45 patients treated at our institution between 1979 and 2004. Data about gender, age, etiology, site of involvement, bacteriology, type of surgery, supportive treatment, accompanying diseases, mortality were collected. Factors contributing to mortality were sepsis, renal failure, liver failure, multi organ failure, disseminated intravascular coagulopathy and long term intubation. Mortalities accumulated in first 23 patients. There was not difference in microbiology, demographics, etiology, site of involvement, debridement technics between first patients and recent patients of the institution. Mortality in necrotizing fasciitis is mostly because of sepsis and associated disorders. Adequate control of the microbiological agent and preventing further contamination of the wound is cardinal part of treatment in NF.