Periorbital necrotizing fasciitis is a soft tissue enfection, usually polymicrobial, characterised by necrosis of fascia and subcutaneous tissue. It frequently involves the groin, abdomen and extremities, but rarely involves the fascial region. In this article a case is presented of a 57-year-old woman who following a kick of cow developed a periorbital necrotising fasciitis. Bacteriological investigations revealed the presence of Streptococcus pyogenes. The virulence of this microorganism requires an aggressive approach to the patient with periorbital necrotizing fasciitis, which is refractory to intravenous antibiotics. Early treatment may limit extensive eyelid necrosis, the resultant secondary deformity, and the need for multiple reconstructive procedures.