Haemorrhagic skin necrosis is a common manifestation of a number of different pathological processes that can evolve dramatically and carry a grave prognosis. The divergent patho-physiological basis of the condition and the many specialities involved in the initial and subsequent care of the patient means that not all patients are seen by wound care professionals. Yet such patients do present to wound healing clinics and wounds invariably develop if the affected area is large. It is therefore important that wound care experts are familiar with the common causes of haemorrhagic skin necrosis and are able to instigate the appropriate investigations and treatment.