For years, activation of coagulation and formation of microthrombi were considered critical mechanisms of tissue damage in sepsis. However, clinical trials with anticoagulants did not show benefits in sepsis patients. In order to check the relevance of activation coagulation as a mechanism of tissue damage in sepsis, we evaluated the presence of vascular microthrombi in autopsies of 51 patients deceased by septic shock in HC-Unicamp.