Sepsis is common in intensive care; it is a common precipitant of acute illness necessitating admission to the intensive care unit (ICU), and complicates stays. ICU departments are characterised by some of the sickest patients, and are responsible for the highest per capita rates of antibiotic use in the hospital. Sepsis can be thought of as a series of physiological responses to the presence of an infection, culminating in organ system dysfunction or failure, with potential long-term consequences among its survivors. Patients are likely to present to the hospital with systemic manifestations of an infective process, such as pyrexia, rigors, tachycardia, tachypnoea and altered level of consciousness. Most centres use a protocolised approach to the management of sepsis incorporating input from microbiology, intensive care and admitting medical teams to optimise therapy for the local patient population and the local hospital setting. Early administration of antimicrobials is crucial in managing sepsis.