Anesthetic management of necrotizing fasciitis of neck associated with Ludwig’s angina is presented. This case was challenging as all the major vessels and tracheal rings were visible from outside. Also because of massive blood loss patient was in hypovolemic shock. Necrotizing fasciitis is a rare, rapidly progressive, life threatening infection process primarily involving the subcutaneous tissue and fascia with thrombosis of the subcutaneous blood vessels. While Ludwig’s angina is a serious, potentially life-threatening infection of floor of the mouth and neck. This condition is notorious for its aggressiveness, rapid progression to airway compromise and high mortality when not treated promptly. These conditions cause severe threat to the patient’s life.

Keywords: Necrotizing fasciitis; Ludwig’s angina; Hypovolemic shock.