Enterocutaneous fistula (ECF) is defined as an abnormal connection between the gas-trointestinal tract and the skin. The majority of ECFs result from surgery, while inflammatory bowel disease, trauma, malignancy, radiotherapy, and diverticulitis are other common causes. The management of ECFs is complex and challenging. We managed a case of high output ECF located in an open abdominal wound in a 67-year-old male. We controlled sepsis with antibiotics, corrected fluid and electrolyte imbalances, and provided nutritional support. To manage wound drainage we used negative pressure wound therapy with a suction pouch. After four months, we performed surgery to manage the ECF. At present, the patient is doing well without any complications.