Septic shock is a life-threatening condition that results from the combined effects of bacteria and the host's chemical mediators of inflammation. Of particular detriment is the hyperdynamic and hypodynamic vasomotor instability that severely compromises the patient prior to the onset of overt bacteremia. The principles of therapy include (1) a prompt diagnosis, (2) removing the source of sepsis, (3) maintaining normal blood pressure through the use of parenteral fluids and inotropes, (4) selecting the appropriate antimicrobial agent, and (5) stringent patient monitoring. Sometimes, despite the optimal use of diagnostic tests and high-quality treatment, the prognosis remains guarded to grave.