© 2021 Royal Australasian College of Surgeons.Background: To report the initial histological evidence on the feasibility of the skin-sparing approach in the treatment of Fournier's gangrene. Methods: We retrospectively reviewed the clinical data and the tissue blocks obtained from patients who had undergone debridement in a tertiary healthcare center by a urologist and a general surgeon. Results: The histological review revealed the prevalence of the intact epidermal layers in the debrided tissues involving necrosed subcutaneous parts. Clinical results of our cohort were compatible with the contemporary series. Conclusion: We can propose that the skin parts without macroscopic necrosis can be spared in the initial debridement in the treatment of Fournier's gangrene, at least in the first debridement. The skin-sparing approach may provide easier and primary closure of the wound without compromising surgical safety in Fournier's gangrene treatment.