Septic shock remains a major cause of morbidity and mortality, and places a large burden on healthcare systems, especially in intensive care patients. Recent epidemiological studies have found an increasing incidence but slightly falling mortality rate with septic shock. However, patients with this condition still have an excessively high risk of death. Septic shock therapy has many components. The initial management is hemodynamic therapy, aimed to maintain adequate organ and cellular perfusion. Patients with septic shock should be treated in an intensive care unit and require early vigorous resuscitation. Fluid infusion should be titrated to clinical end points of volume repletion, maintaining adequate hemoglobin concentration. When fluid administration fails to restore adequate organ perfusion, therapy with vasopressor agents should be initiated. In recent years, exciting advances have been made in the understanding of the pathophysiology and treatment of sepsis, aimed at improving survival. Recent studies indicate that some patients with septic shock might benefit from low dose corticosteroid and activated protein C.