Fever is a classic symptom of sepsis in critically ill patients and commonly prompts ICU physicians to evaluate for infection. Despite the frequency with which fevers occur in patients in the ICU, there is surprisingly little consistency among intensivists regarding whether fevers should be treated.1 Certainly, there are subsets of critically ill patients—those with neurologic injury or active myocardial ischemia, for example—who are particularly susceptible to the deleterious effects of fever and should undoubtedly receive antipyretic therapy.2 Sepsis, however, is a complex and heterogeneous disease. Although some patients may benefit from the protective effects of fever control, others may not, depending on the severity of their disease and their degree of end-organ dysfunction. Unfortunately, there are few randomized controlled trials to guide clinical practice. Based on the available evidence, though, our opinion is that fever should not routinely be treated in patients with septic shock.