We conducted a retrospective review of 11 cases of adult cervical necrotizing fasciitis that were treated at our institution over a period of 5-plus years. The most common etiology was a dental infection, which was seen in 7 of the 11 patients (64%). Most cultures were sterile because all of these patients had been referred to us after they had already been treated elsewhere with intravenous antibiotics and without surgical intervention. Under our management, patients spent an average of 21.6 days in the hospital, and they underwent an average of 1.6 debridements under general anesthesia. Aggressive wound care, broad-spectrum antibiotic therapy, and timely surgical intervention resulted in an overall survival rate of 91% (10/11), including a 75% survival (3/4) for patients with thoracic extension.