Sepsis as a disease has received renewed interests since recent publications of a revised clinical definition and crucial clinical trials showing the benefits of early goal-directed resuscitation, recombinant human activated protein C, and low-dose corticosteroids. The epidemiology of sepsis has also been further examined. Management guidelines and international quality improvement efforts have been developed targeting increased disease identification, clinician education, and optimal patient care with the result of decreasing patient mortality. The evidence suggests that early recognition and early intervention are most important in affecting outcome. This article will summarize these developments in the diagnosis and management of sepsis at the turn of this century.