Severe sepsis and septic shock are the leading causes of death in children admitted to any intensive care unit of a developing country. The most important reason for unfavorable outcomes in these children is the severity of illness at presentation which makes these children refractory to any goal directed measures undertaken thereafter. Apart from the agent and host related factors, environmental factors such as delay in seeking timely and appropriate healthcare and use of inappropriate modes of transport may be equally responsible in adding to the disease severity in these children. In this article we shall briefly review the importance of early recognition and treatment and the probable reasons for delay in our set up.  

Key word: Sepsis; Septic shock; Transport; Resuscitation; Golden hours; Early goal directed therapy.