Introduction The inflammatory response to an invading pathogen in sepsis leads to complex alterations in hemostasis by dysregulation of procoagulant and anticoagulant factors. Recent treatment options to correct these abnormalities in patients with sepsis and organ dysfunction have yielded conflicting results. Using thromboelastometry (ROTEM ® ), we assessed the course of hemostatic alterations in patients with sepsis and related these alterations to the severity of organ dysfunction.