Shock may be defined in physiologic terms as a state in which the circulatory system is unable to meet the cellular needs for perfusion to maintain tissue homeostasis. Septic shock is defined as a state of tissue hypoperfusion arising from a documented infection or the infection-induced release of inflammatory mediators. Successful resuscitation depends on careful patient assessment to determine the causal organisms of infection and appropriate antibiotic therapy targeting the key pathogens. In many cases, where high cardiac output is opposed by reduced left ventricular filling pressure despite fluid loading, administration of inotropic agents may be warranted to alleviate myocardial dysfunction. Septic shock requires rapid intervention to stop the downward spiral to multiple organ failure and death. (J Crit Illness. 2002; 17(9):357-363)