Objective To investigate whether three biallelic polymorphisms at positions -592, -819 and -1082 in the promoter region of the IL-10 gene are associated with increased incidence of severe sepsis.Methods The IL-10 -592, -819 and -1082 polymorphisms were typed using polymerase chain reaction followed by digestion with the restriction enzymes RsaⅠ, MaeⅢ and MnlⅠ, respectively.Results Patients with severe sepsis were more likely to have IL-10 -1082 allele 1, compared with controls (P<0.05). Genotype distribution of the IL-10 -1082 polymorphism significantly differed between patients and controls (P<0.05). However, the allele frequencies and genotype distribution of the IL-10 -1082 polymorphism did not differ between surviving and dead patients (P>0.05). No significant differences in the genotype distribution and allele frequencies of the IL-10 -592 and IL-10 -819 polymorphisms were observed between patients with severe sepsis and heathy controls, nor between surviving and dead patients (P> 0.05). Conclusions The polymorphism at position -1082 in the promoter region of the IL-10 gene may be associated with susceptibility to severe sepsis. In constrast, the other two highly linked IL-10 polymorphisms are not associated with incidence or the outcome of severe sepsis.