Two uncommon cases of sepsis-associated Purpura fulminans (PF) caused by urinary tract infection are herein reported. The first case involved an 81-year-old man, and the second an 80-year-old woman; both developed septicemia and disseminated intravascular coagulation (DIC). After admission to the intensive care unit (ICU), progressive purpuric skin necrosis became evident on the fingers and toes. Blood and urine cultures were positive for both Escherichia coli and Enterococcus faecalis in the first case and for Escherichia coli in the second. The patients were discharged from the ICU on day 17 and 36, respectively. All areas of necrosis subsequently separated from the underlying tissue. Because the mortality rate associated with PF is very high, priority must be given to general and symptomatic supportive therapy in patients with sepsis-associated PF.