Objectives: To determine the occurrence rate, outcomes, and the characteristics of severe sepsis in surgical intensive care units in multiple medical centers within China and to assess the cost and resource use of severe sepsis in China.Design and Setting: Prospective, observational study of surgi-cal intensive care unit patients at ten university hospitals in six provinces in China.Patients: All adult admissions in studied intensive care units from December 1, 2004, to November 30, 2005.Interventions: None.Measurements and Main Results: The criteria of severe sepsis were based on the American College of Chest Physicians/Society of Critical Care Medicine consensus conference definition. Anal-ysis of data from 3,665 intensive care unit admissions identified 318 (8.68％) cases of severe sepsis, 64.8％ of which were males. The median age (interquartile range) of patients with severe sepsis was 64 (47-74) yrs. Microbes had been isolated from 228 (71.7％) patients, including 171 (53.8％) with Gram-negative bac-teria and 146 (45.9％) with Gram-positive bacteria. A total of 90(22.0％) patients had invasive fungal infection, 20 (6.3％) of which had fungemia. The abdomen was the most common site of infec-tions (72.3％), followed by lung (52.8％). The overall hospital mortality of severe sepsis was 48.7％. Risk factors for hospital mortality included age, chronic comorbidity of malignant neo-plasm, Gram-positive bacterial infection, invasive fungal infec-tion, admission Acute Physiology Score, and admission Sequential Organ Failure Assessment score of respiratory dysfunction and cardiovascular dysfunction. The median Therapeutic Intervention Scoring System-28 score was 43 (38-49). The mean hospital cost was $11,390 per patient and $502 per patient per day.