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Necrotizing fasciitis is a rapidly spreading progressive infection of the fascia with necrosis of the subcutaneous tissues. Primary necrotising fasciitis of the breast is extremely rare and hence we report the case of a 55-year-old woman presenting to our hospital with primary necrotising fasciitis of the breast in a state of systemic septic shock. She was admitted in surgical intensive care unit and treated with resuscitation, intravenous antibiotics and aggressive debridement. We discuss the details of the case, our treatment approach, the outcome and also briefly review the literature.