Sepsis is a significant public health concern, particularly affecting individuals over 70 years in developed countries. The increasing aging population and their heightened vulnerability to sepsis contribute to high mortality rates and long-term morbidity. Managing sepsis in older patients is more challenging due to the need to identify, document, prevent, and treat sepsis effectively. Frailty, disease severity, and comorbid conditions are crucial factors influencing health outcomes. Personalized treatment plans that consider patient preferences and potential for recovery are essential. This review highlights the key aspects to consider when dealing with critically ill older patients with sepsis, emphasizing the importance of comprehensive assessment and personalized care. The review also discusses the challenges in diagnosing sepsis in older individuals, the sources of infection, and the management of sepsis, including antibiotic therapy, resuscitation, and additional factors such as sedation and non-invasive ventilation. The long-term outcomes of sepsis survivors, including cognitive and functional decline, are also addressed. The goal is to improve outcomes by enhancing early recognition, prompt source control, and timely antibiotic administration, while also focusing on long-term care and quality of life.Sepsis is a significant public health concern, particularly affecting individuals over 70 years in developed countries. The increasing aging population and their heightened vulnerability to sepsis contribute to high mortality rates and long-term morbidity. Managing sepsis in older patients is more challenging due to the need to identify, document, prevent, and treat sepsis effectively. Frailty, disease severity, and comorbid conditions are crucial factors influencing health outcomes. Personalized treatment plans that consider patient preferences and potential for recovery are essential. This review highlights the key aspects to consider when dealing with critically ill older patients with sepsis, emphasizing the importance of comprehensive assessment and personalized care. The review also discusses the challenges in diagnosing sepsis in older individuals, the sources of infection, and the management of sepsis, including antibiotic therapy, resuscitation, and additional factors such as sedation and non-invasive ventilation. The long-term outcomes of sepsis survivors, including cognitive and functional decline, are also addressed. The goal is to improve outcomes by enhancing early recognition, prompt source control, and timely antibiotic administration, while also focusing on long-term care and quality of life.