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Aim: Fournier’s gangrene is a surgical emergency necessitating urgent debridement and aggressive antimicrobials. Early recognition of high-risk patients enable timely critical care utilization. Controversies existed in scoring systems like Fournier Gangrene Severity index (FGSI), Uludag FGSI and simplified FGSI. No local data is available on their applicability and valid prognosticating factors, hence our study aiming to improve triage and mortality. Methods: Fifty patients with Fournier’s gangrene from 2006 to 2015 were retrospectively reviewed. Baseline demographics, physiologic and laboratory values, management options, also parameters in established scoring systems were compared between survivors and non-survivors via univariate analyses. ROC curve analysis was performed to evaluate the diagnostic performance of three aforementioned scores. Results: Mortality was 20%, compatible with international literature. Non-survivors had higher median age (63 vs 53, p=0.05), smoking (70% vs 30%, p=0.03), diabetes (80% vs 38%, p=0.03), immunosuppression (100% vs 68%, p=0.046), orchidectomy (30% vs 2.5%, p=0.022), higher serum creatinine (1.2mg/dL vs 0.91mg/dL, p=0.042) and lower haematocrit (31% vs 36%, p=0.006). Defunctioning stoma and suprapubic catheterization were not useful in reducing mortality. For scoring systems, no significant difference in translated score levels was seen. ROC curve analysis showed low AUC 0.588 for sFGSI, whereas that for FGSI and UFGSI were 0.798 and 0.833 respectively, but not statistically significant. Conclusion: Elderly, smokers, diabetics or immunocompromised, higher creatinine or lower haematocrit level and patients requiring orchidectomy indicate poorer prognosis and may benefit from intensive care. Current scoring systems either perform poorly or have troublesome frontline application. This represents the first local study of such intent. EFP2