INTRODUCTION: Sepsis is a pervasive problem worldwide, and typically affects persons with significant underlying diseases, immunosupression, or major trauma. Despite recent advances in therapy and intensive care medicine, mortality rates have remained essentially unchanged over the past decade. Furthermore, sepsis is poorly defined, usually incorporating septicemia, SIRS and severe sepsis. OBJECTIVE: The purpose of this study was to determine the outcomes and utilization of hospital and ICU days in patients with severe sepsis. METHODS: This evaluation was conducted as part of a prospective, multi-center, cohort study ( Sepsis Longitudinal Epidemiological Clinical Outcomes Tracking [SELECT] registry) in 398 patients with severe sepsis of presumed infectious origin recruited through 45 ICU units across the US. For each ICU admission, patient demographic, ICU length of stay (LOS), hospital LOS and hospital discharge status (dead or alive) was collected. In addition, data concerning source of infection, comorbidities and treatments was also collected. RESULTS: In patients with severe sepsis, the most common comorbidities were CVD (38%), respiratory failure (36%) and diabetes (26%), and, the majority were admitted from home (73%). The most common sources of infection were pulmonary (44%) and abdominal (23%). Overall mortality in patients with severe sepsis was 42%. ICU survivors had significantly longer mean hospital LOS (29 vs. 18 days, p <0.01) and ICU LOS (18 vs. 13 days, p <0.01) compared to non-survivors. Both groups received similar treatment. CONCLUSION: Based on these observations, severe sepsis of presumed infectious origin is associated with a high mortality rate and significant utilization of hospital resources.