A 71-year-old male patient was operated on in a septic state (tachycardia, hypotonia, fever peaks, disorientation) because of an occluding tumour of the biliary tract. Ketamine was used as the main anaesthetic. Mean arterial pressure increased markedly and diuresis started during the anaesthesia. The inotropic support (dopamine, dobutamine, noradrenaline) could be reduced. Ketamine anaesthesia seemed to have a beneficial haemodynamic effect in septic shock.