【Abstract】 Background Cationic antimicrobial peptides is one group of small peptides which is retained in the long-term evolutionary process. On the one hand，cationic antimicrobial peptides mediate the innate and adaptive immune responses of sepsis, play important roles in defending the body against invading microorganisms and repairing damaged tissue; on the other hand, in response to infection or tissue injury, cationic antimicrobial peptides as endogenous danger-associated molecular patterns (DAMPs) released into the local tissue and circulating, cause disorders of the internal environment and development of sepsis. Objective Re-understanding of the role cationic antimicrobial peptides in the immune response in sepsis. Content Systematically illustrate that cationic antimicrobial peptides are double-edged swords in modulation of the innate and adaptive immune response of sepsis. And focus on the mechanisms of AMPs medicate the immune injury of sepsis in recent years Trend To provide scientific basis for further clarify the cationic antimicrobial peptides in the pathogenesis and mechanisms of sepsis.