In our surgical practice in the last few years, we notice an increase of severe soft tissue infections. One of the most damaging soft tissue infections we consider the necrotizing fasciitis. The mortality is high and the diagnosis is difficult. The deep necrotizing infection leads to vascular occlusion, ischemia and tissue necrosis. We notice a loss of sensibility of the affected areas because of the damaged nerve extensions. In the Clinic of Septic Surgery in Multipurpose Hospital for Active Treatment and Emergency Medicine "N. I. PIROGOV", Sofia, Bulgaria, on the base of 32 cases with necrotizing fasciitis we determined basic diagnostic signs. Those signs can be of assistance to surgeons in their medical practice who have or will experience this severe infection requiring urgent surgical management.