The association between necrotizing fasciitis and tuberculosis is extremely rare. We report two cases in which the initial clinical presentation of tuberculosis was that of necrotizing fasciitis proven by histopathology. Repeated adequate surgical debridement was performed in both. In one patient, acid-fast bacillus was cultured from a discharging sinus one year postoperatively. The other patient was diagnosed to have pulmonary tuberculosis two months postoperatively. The diagnosis of tuberculosis should be suspected in patients with necrotizing fasciitis with recurrence or unexpected slow response to surgery.