The currently high letality rate of uroseptic shock may be reduced by early recognition of symptoms and adequate therapy with elimination of causes. Decisive for the septic shock are initial disturbances of the microcirculation in the presence of hyperdynamic circulatory regulation with following disorders of the coagulation system, tissue metabolism, acid-base-balance and heart contractility. In the therapeutic armament the important role of vasoactive substances is stressed. In an analysis of 59 patients suffering from urosepsis the intrinsic and iatrogenic causes, the bacterial spectrum and the emergency operative interventions are evaluated, whereas a letality rate of nearly 12% and an injury grade of 34% are estimated.