Background　Severe sepsis is a life-threatening disease that is defined as a complex and systemic inflammatory response to infection with the presence of multiple organ dysfunction. When sepsis occurs, both pro-inflammatory and anti-inflammatory processes exist in host immunity, and the balance between them determines the pathological progress as well as clinical outcome. An uncontrolled and amplifying pro-inflammatory response was initially believed to be the major cause of mortality in sepsis. However, anti-inflammatory treatments do not improve the survival rate of patients with sepsis, even reduce it sometimes. With the improvement of supporting treatments, most of patients with sepsis can survive from initial hyper-inflammatory phase, but they ultimately die from uncontrolled secondary infection due to the protracted immunosuppressive phase after initial hyper-inflammatory phase. In recent years, it has been increasingly recognized that immunosuppression is the main cause of death in patients with sepsis, however, the treatment for sepsis-induced immunoparalysis is lacking.　Objective　To provide a theoretical basis for better diagnosis and treatment of sepsis.　Content　This paper reviewed the latest progress on the pathological mechanisms for sepsis-induced immunoparalysis, and proposed treatment strategies as well.　Trend　It is necessary to understand the pathogenesis of sepsis, monitor the host immune status, and treat the patients properly based on their immune status. This immune-based therapy will be beneficial for patients with sepsis in clinical practice.