Widespread cutaneous necrosis (WCN) associated with antiphospholipid antibodies is rare. Its mechanisms have yet to be elucidated, and there are no well-established guidelines for its management. We describe a woman who had two episodes of WCN related to surgical manipulation for urinary tract obstruction and urinary tract infection. Lupus anticoagulant was always positive. In the second episode anticardiolipin antibodies were elevated, and protein C levels were temporarily decreased. We found only ten previously reported cases of WCN associated with antiphospholipid antibodies, none of which were related to surgical manipulation.