Introduction: This study reviews our understanding with Orofacial space infections requiring surgical intervention, including cervical necrotizing fasciitis in medically compromised patients. The purpose of the study was to recognize predisposing and aggravating factors of the disease and identify the possible factors that can lead to life-threatening complications and slow down the healing process Materials and methods: We associate the results to previous data from 1985 to 2005 to discover possible changes and varying trends. The features of four lethal cases are defined. This retrospective analysis comprises patient data from 2005 to 2015 in tertiary referral hospital and in total, 277 patients were seen. Results: Surgical drainage through a neck opening with/without intraoral incision was made in 215 (77.6%) patients; an intraoral incision was only done in 62 patients (22.4%). ICU care was needed in 66 (23.8%). Odontogenic etiology (44.8%) was the most usual origin. The most common comorbidity was a psychiatric disorder and/or dementia and occurred in 55 (19.9%) subjects. Patients with underlying illnesses were more likely to be admitted to the ICU (p=0.020), required a longer ICU stay (p=0.004) and repeated surgery (p=0.009). Gas formation seemed to be predictive of a more severe course of infection. Early extraction of the odontogenic foci was connected to a lower length of stay (LOS) (p=0.039). Conclusion: The yearly numbers have increased from 14 to 24 cases per year when linked to preceding data. OFSIs remain a cause of fatal complications; the mortality was 1.4% and overall complications ensued in 61 (22.0%) patients.