Sepsis is one of the most commonly encountered scenarios in critical care medicine. In spite of massive advances in critical care, the incidence and mortality burden of sepsis remains quite high. Resuscitation of septic patients is one of the most researched topic in modern day medicine. Sepsis resuscitation was initially influenced by observation of supra-normal survivor values generating the idea of goal directed therapy. Subsequent studies resuscitating septic patients to these supra-normal values revealed no benefit and possible harm in this strategy. In order to resolve this issue, early resuscitation of septic patients to fixed haemodynamic goals at the most proximal point of disease process was proposed in 2001 and was named ‘early goal directed therapy’. The study demonstrated a significant mortality benefit compared to usual care. This promising result led numerous trials to be conducted to test the hypothesis. Finally, after years of controversy, three large, multicentre trials were conducted in order to reach a conclusion and their results have recently been published. With the background of these recent changes, this review was conducted to describe the changes in ‘early goal directed therapy’ with time and to assess the available evidence guiding its use, specially focusing on the large new trials. This review also briefly outlines the pathophysiology of septic shock, describes the historical background of early goal directed therapy, and assesses the evidence regarding goal directed therapy in other physiological insults. To achieve these objectives, an extensive search in PubMed and general databases such as Google and Google scholar was carried out for published works. Studies were considered eligible for inclusion if they were randomised, controlled trials comparing early goal directed therapy to usual care in resuscitation of septic patients. After quality assessment of the selected studies, four studies were considered eligible to be included in the literature review. Analysis of these trials showed early goal directed therapy has no mortality benefit over patients receiving usual care. The analysis also revealed that the beneficial effects of early goal directed therapy in organ dysfunction could not be replicated in the newer three trials. Another important finding was that early goal directed therapy was not found to be cost effective. However, it should be taken into consideration that tremendous advance has occurred in critical care practice within the interval from the original trial to the publication of these newer trials and some components of the protocolised care may have been incorporated in routine care of septic patients. Contrary to these findings in patients with septic shock, goal-directed therapy has shown some promise when implemented in the peri-operative period. One large study along with meta-analysis revealed a lower incidence of morbidity and complications in patients treated with goal directed therapy compared to patients receiving usual care. However, no mortality benefit was demonstrated between the two groups. Overall, the publication of these new trials have made it evident that strict adherence to goal-oriented protocol is unlikely to be more beneficial and usual care based on good critical care practice should be the employed in sepsis resuscitation.