Abstract: Sepsis and septic shock continue to be a devastating syndrome that is associated with morbidity and mortality. Sepsis and septic shock are time-critical conditions. Emergency department(ED) plays a vital role in the identification, risk stratification, and resuscitation for patients with sepsis or septic shock. The "sepsis bundle" has been reported to improve the outcome of sepsis. In April 2018, the Surviving Sepsis Campaign issued an " hour-1 bundle" for patients with suspected sepsis. Getting this" hour-1 bundle" done in less than 1 hour will be a challenge for emergency physicians.The aim of this review was to discuss the process, management, and possible future policies to improve the compliance to the bundle and quality metrics so that encourage a rapid and high-quality care of sepsis and septic shock in the ED.