Microcirculatory dysfunction is a pivotal element of the pathogenesis of severe sepsis and septic shock. Technological development, including sidestream darkfield videomicroscopy, now allows for bedside assessment of the microcirculation. A number of clinical studies have established the importance of the microcirculation in sepsis. The objective of this review is to discuss human trials that have assessed interventions aimed at improving microcirculatory flow in patients with sepsis.