Background: Severe sepsis is common and frequently fatal and represents a significant health care burden. Sepsis is a syndrome of physiologic, pathologic, and biochemical abnormalities induced by infection. Aim of the work: This study examines the ability of serum lactate/albumin ratio to predict outcome regarding organ dysfunction and mortality in severe sepsis and septic shock. Materials and Methods: It is a prospective observational study conducted on 50 patients with severe sepsis and septic shock according to the (SCCM/ESICM/ACCP/ATS/SIS) International Sepsis Definitions Conference 2001 and fifty healthy age matched individuals as a control group. Results: Lactate/albumin ratio was higher on day 0 and 1 in the study group than in control group (p value <0.001). Also, it was significantly higher in patients that needed mechanical ventilation than patients who didn't (p value p valuep value<0.001).Conclusion: Lactate/albumin ratio is a reliable biomarker for prediction of outcome as regards organ dysfunction and mortality in patients with severe sepsis and septic shock.