Nicolau syndrome(NS)is a rare cutaneous adverse reaction after intra-muscular or intra-articular injection.Clinical features of NS are presented by three typical phases(initial,acute and necrotic phases).The cause of NS is acute vasospasm,inflammation of arteries and thromboembolic occlusion of arteriole related various drugs.Many results of laboratory test,imaging studies and histopathology are reported and are associated with disease status.Three phase treatment is recommended for the patients with NS.Initially pain control and rule out differential diagnosis and in acute phase steroid therapy,heparin and pentoxifylline are useful.In necrotic phase,surgical treatment is needed depending on size of the affected site.NS is not well understood so far,however three phase treatment could lead to good result on basis of literature review.