Negative pressure wound therapy (NPWT) is a cornerstone of wound management, employing sub-atmospheric pressure to optimise healing. NPWT induces mechanical stress, promoting epithelial proliferation and angiogenesis, while concurrently removing excess inflammatory substrate. Widely applied for the treatment of complex wounds like diabetic ulcers, burns and pressure injuries, as well as for closed surgical incisions and skin grafts, NPWT has witnessed a rich historical trajectory. NPWT finds its origins in ancient Egypt ~1500 BCE, where cupping glasses were employed for blood and fluid drainage from wounds. Similar techniques, known as Chinese fire cupping, existed ~1000 BCE. NPWT first appeared in Western medicine in the Roman empire where “sucking healers” used direct oral suction for wound management in the Roman army. In the 18th century, Anel wished to move away from the archaic act of “lip service” and invented a suction syringe. The 19th century saw the revival of cupping glasses, enhanced with suction tubing, but NPWT finally took large steps forward in the late 20th century. Bagaoutdinov, a Russian surgeon developed negative pressure units using foam dressings during the Soviet-Afghanistan war, and the pivotal advancement came with the creation of the vacuum-assisted closure device by Argenta and Morykwas, in the 1990s. This presentation explores NPWT's historical continuum, encompassing its inception in ancient civilizations to its modernisation in the late 20th century. Beyond its conventional applications, NPWT's contemporary versatility extends even to the management of oesophageal perforations. The longevity and adaptability of NPWT underscore its ongoing evolution and pivotal role in diverse wound care.