Despite their potential benefits, corticosteroids have adverse affects and the benefits and risks must be balanced in determining whether they should be used or not. Some of the serious adverse affects noted in patients with critically illness have included superinfections and critical illness polyneuromyopathy. This article reviews the subject of steroid treatment of patients with septic shock and weighs the advantages and disadvantages of steroid treatment. It reviews and contrasts several low- and high-dose steroid studies, and makes recommendations for future practice.