Sepsis is a common illness of intensive care unit patients that carries high morbidity and mortality, and increases hospital costs. Although mortality from sepsis remains high when compared with other critical illnesses, it has declined over the last few decades due to several adjunctive therapies and focused care programs or guidelines. In 2004, an international guideline was published that the bedside clinician could use to improve the outcomes in severe cases of sepsis and septic shock. Several landmark studies recently demonstrated that therapeutic strategies may substantially reduce mortality. The Surviving Sepsis Campaign Guidelines for Management of Severe Sepsis and Septic Shock: 2008 was updated using a new evidence-based methodology system for assessing the quality of evidence and the strengths of recommendations. Evidence-based recommendations regarding the acute management of sepsis and septic shock are the first step toward improving the outcomes of critically ill patients. This article discusses the guidelines and current insights into sepsis treatment.