Data sources. We report one case and analyzed 15 Japanese cases concerning multiple organ failure induced by wasp stings. Data Extraction. Thirteen of 15 cases were associated with skin hemorrhage or necrosis after wasp stings. The mean number of stings (± standard error) in the patients who died (59 ± 12) was significantly greater than that in those who survived (28 ± 4, p=0.01). Conclusion. The occurrence of skin hemorrhage or necrosis after wasp stings is extremely rare and multiple organ injury after wasp stings is also a rare complication. Thus, cutaneous hemorrhaging or necrosis findings after wasp stings may suggest the development of multiple organ injury. In addition, the number of stings may play an important role in predicting outcome.