Purpose Necrotising fasciitis is a severe soft tissue infection associated with morbidity and mortality. Reports of its management span a range of clinical settings. This review aims to collate studies describing necrotising fasciitis managed in explicitly stated rural settings and to summarise reported clinical presentation, diagnostic processes, management approaches, and outcomes. Methodology A qualitative review was undertaken using studies identified from PubMed, MEDLINE, and EMBASE database searches. Publications were eligible if they described necrotising fasciitis or necrotising soft tissue infection managed in rural or remote settings. Case reports, case series, and observational cohort studies were included. Studies without a clearly stated rural context or those addressing other necrotising conditions were excluded. Information was extracted from abstracts and summarised descriptively. Results The available literature comprised a small number of observational reports. Common themes included delayed presentation, diagnostic uncertainty, and limited access to specialist services in rural settings. Management was predominantly surgical, with early operative debridement frequently described and limb amputation reported in some cases. Diagnostic imaging and laboratory assessment were used to support clinical decision-making. Reported outcomes included postoperative morbidity, the need for repeat surgical intervention, and mortality. Conclusion The published evidence on necrotising fasciitis in rural settings is limited and observational. Nevertheless, recurring themes highlight challenges related to delayed diagnosis, resource constraints, and the importance of timely surgical management. These findings are relevant to rural clinical practice and may inform service planning and future research.