Background:- Early goal-directed therapy (EGDT) provided a consensusderivedprotocol to reverse the hemodynamic disturbances by adjustmentof cardiac preload, afterload, and contractility to balance oxygen deliverywith oxygen demand after early identification of patients with severe sepsisand septic shock. Objective:- To evaluate the concept of EGDT; providedat the earliest stages of severe sepsis and septic shock; regarding theclinical course and final outcome. Methods:- A prospective, randomized,single center study were conducted on 30 patients admitted with severesepsis and septic shock, and treated according to the protocol of EGDTwhich consists of aggressive hemodynamic support during the first 6 hoursafter sepsis is recognized, to achieve certain physiologic targets. Another30 age matched patients served as control group received onlyconventional sepsis treatment. Both groups were matched by APACHE IVscore (within the 1st 6 hours). MODS and SOFA scores were calculated atbaseline and everyday until ICU discharge or death. Results:- EGDT;provided at earliest stage of severe sepsis or septic shock; has: (1)significant improvement of patient outcome as indicated by significantreduction of SOFA and MODS scores from the second day of hospital stay(P values = 0.006 for SOFA and 0.03 for MODS), (2) significant reductionof ICU stay for surviving patients (P value = 0.02), (3) significantreduction of the 28 days mortality (40% vs 73.3% with P value = 0.009),(4) non significant reduction of the need for organ supportive measures (Pvalues = 0.24 for the need for mechanical ventilation and 0.67 for acutehemodialysis). Conclusion:- EGDT provide significant benefits withrespect to outcome in patients with severe sepsis and septic shock.