eptic shock is a frequent complication in intensive care unit that can result inmultiple organ failure and death. In addition, recent data suggested that severe sepsis andseptic shock represent an economic burden. Therefore, septic shock is an important publichealth problem.Method: In this review, we will focus on the recent evidences concerning the stages of septicshock, the complex macrocirculation and microcirculation relationship, and the impor-tance of those evidences for future resuscitation goals and therapeutic strategies duringlate septic shock.Result: Recently, two stages of septic shock are suggested. In early stage, hypovolemia is themain contributing factor. During this stage, macrocirculatory and microcirculatorychanges run parallel, and fluid resuscitation seems to be effective in restoring the hemo-dynamic parameters. Late stage of septic shock is characterized by complex microcircu-lation and macrocirculation relationship.Conclusions: Although early goal-directed therapy is a stepwise approach in the treatmentof septic shock, tissue perfusion remains an important factor that contributes to septicshock outcome. Because appropriate monitoring of tissue perfusion is a matter of debt, theideal therapeutic strategy remains a controversial issue that needs further investigations