Sepsis is associated with a high incidence of mortality and morbidity, however with appropriate strategies for monitoring and early targeted intervention mortality rates decline. This article examines the basic pathophysiology of the inflammatory response to tissue injury and the effects this has on circulation. A partnership of the Society of Critical Care Medicine, the European Society of Intensive Care Medicine and the International Sepsis Forum has developed the surviving sepsis strategy, which includes the sepsis six treatment pathway and early goal-directed therapy incorporating the six-hour care bundle.