The article discusses the evolution and challenges of critical care, particularly in the context of the global burden of critical illness. It highlights that critical care has evolved from treating poliomyelitis victims to managing severely ill patients globally, with a growing recognition of its importance. The burden of critical illness is higher than generally appreciated and is expected to increase due to an aging population. However, critical care capacity is limited in many developing countries, and efforts to improve care in these settings are underway. The article also addresses the financial and demographic challenges posed by an aging population and the impact of natural and human-generated events on critical care demand. It emphasizes the need for better measurement of the global burden of critical illness and the development of scalable preventive and therapeutic interventions. The specialty of critical care must adapt to meet the demands of an aging population and handle the consequences of various crises, while managing high costs and resource constraints.The article discusses the evolution and challenges of critical care, particularly in the context of the global burden of critical illness. It highlights that critical care has evolved from treating poliomyelitis victims to managing severely ill patients globally, with a growing recognition of its importance. The burden of critical illness is higher than generally appreciated and is expected to increase due to an aging population. However, critical care capacity is limited in many developing countries, and efforts to improve care in these settings are underway. The article also addresses the financial and demographic challenges posed by an aging population and the impact of natural and human-generated events on critical care demand. It emphasizes the need for better measurement of the global burden of critical illness and the development of scalable preventive and therapeutic interventions. The specialty of critical care must adapt to meet the demands of an aging population and handle the consequences of various crises, while managing high costs and resource constraints.