We report traumatic necrotizing periorbital cellulitis attributed to g
roup A beta-hemolytic streptococci in a 4-year-old child. The infectio
n was successfully treated via surgical cleansing, drainage, and graft
ing. The virulence of this organism requires an aggressive approach to
the patient with periorbital cellulitis, which is refractory to intra
venous antibiotics. Early treatment may limit extensive eyelid necrosi
s, the resultant secondary deformity, and the need for multiple recons
tructive procedures.