Chronic wounds are difficult to heal, and typically need periodic debridement and infection management. A strange but hopeful alternative is the use of therapeutic fly larvae, sometimes known as maggots, to debride and assist the healing of such wounds. Larval treatment, in particular using Lucilia sericata, utilizes the natural capacity of the larvae to feed on dead tissue, eliminate harmful microbes and biofilms, and produce enzymes and antimicrobial compounds that may aid tissue healing. Although loose larvae may be challenging to utilize due to escape and patient acceptance, modern enclosed systems such as BioBag? provide a more practical and regulated alternative. Recent case experience has shown this strategy to be helpful in the elimination of necrotic tissue and moving toward wound healing. The development of larval delivery technologies and an increased knowledge of their biological properties have made larval therapy a promising approach for the treatment of difficult-to-heal chronic wounds.