OBJECTIVES: To evaluate the clinical outcomes and direct costs associated with the treatment of severe sepsis in intensive care units (ICUs) in Poland. METHODS: Web-based Severe Sepsis Registry was founded to collect clinical data and information on resources used for severe sepsis patients management in Poland. Patients were hospitalized in 108 ICUs from 1st April 2003 to 2nd April 2004. As payer’s perspective was adapted only direct medical ICUs costs were analyzed and encompassed: fixed costs of ICU stay, organ support, medical procedures and drugs. Unit costs were calculated using drugs retail prices, hospital accounts systems data and medical procedures tariffs contracted by National Health Found. Costs are expressed in PLN (1PLN=0.4808 Euro PPP’2003). RESULTS: A total of 1168 severe sepsis patients were registered. The mean ICU length of stay was 18.99 days (95% CI: 17.6; 20.4). Total individual treatment cost was estimated at 53,799 PLN (25,867€), 95%CI: 50291-57307 PLN (24,180-27,553€). The mean ICU daily cost amounted to 2833 PLN (1362€). The main costs components included: ICU stay fixed costs (76.45%), antibiotics (9.32%), (activated) drotrecogin alfa (5.34%), ATIII (2.66%), mechanical ventilation (2.25%) and renal replacement therapy (1.63%). The ICU survival rate amounted to 45.1%, thus the mean cost per one survivor equaled 119 236 PLN (57,329€). CONCLUSIONS: Severe sepsis is associated with poor prognosis and substantial treatment cost mainly resulting from high fixed cost of ICU stay.