Abstract: OBJECTIVE To explore the clinical characteristics of Vibrio infection-associated necrotizing fasciitis (VVNF) and treatment strategies. METHODS The medical data were collected from 11 patients with VVNF who were treated in Guangdong Province Zhongshan Hospital of Traditional Chinese Medicine from Aug. 2023 to May 2025 and were retrospectively analyzed. RESULTS The elderly male patients (81.82%) were dominant among the enrolled patients, all of whom had the history of seafood-related puncture wounds or seawater exposure, with the clinical symptoms presenting swelling, pain, ecchymosis, and necrosis of the injured limbs, the upper extremities most commonly affected. 91.98% of the patients were complicated with underlying diseases, with hypertension, hyperuricemia, type 2 diabetes mellitus and liver diseases most common. The patients showed the remarkable rise of white blood cell counts, C-reactive protein, procalcitonin, interleukin-6 and creatine kinase and the significant decline of hemoglobin and blood platelet count. All of the patients had coagulation disorders. There were 8 patients with the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score no less than 6 points. All of the patients received antimicrobial therapy, of whom 8 were treated with baseline therapy of cefoperazone sulbactam combined with levofloxacin, 2 were treated with levofloxacin therapies, and 1 was treated with imipenem and cilastatin sodium plus levofloxacin plus vancomycin. All of the patients received surgical debridement, of whom 4 needed to undergo amputation due to severe limb necrosis. There were 10 patients who received intensive case, including 5 cases of mechanical ventilation, 6 cases of renal replacement therapy and 2 cases of plasma exchange therapy. Totally 4 patients died, 7 survived, 5 of whom were completed cured, and 2 were left with varying degree of limb dysfunction. CONCLUSIONS VVNF is characterized with acute onset, rapid progression and high mortality rate, predominantly affecting the male coastal residents with underlying diseases, primarily via cutaneous exposure. The major clinical manifestations include the redness and swelling, pain, ecchymosis, ulceration, necrosis, and numbness of the injured limbs. The early diagnosis is based on the clinical characteristics, clinical laboratory tests, LRINEC score and imaging findings. The multidisciplinary collaboration is necessary for the treatment. The early debridement (within the golden 24-hour window) combined with third generation cephalosporins/quinolones is crucial to the treatment, and the active organ function support may improve the prognosis.