【Abstract】 Background Integrated application of vasoactive agents and fluid resuscitation to attain ideal hemodynamic parameters is the basic strategy of contemporary shock treatment. The hemodynamic features of shock patients are deficiency of effective circulating volume, which leads to microcirculatory disturbance and functional lesion of tissue or organ. Shock treatment should aim at improvement of microcirculation and tissue oxygenation status. Objective Recently, with further acquaintance of pathogenesis underlying various shocks, more recognition on the role vasoactive agents’ play in shock treatment and microcirculation regulation has been achieved. Therefore, the reassessment has been made about the application value of vasoactive agents, which are reviewed in this article. Content In this article, we review the composition of microcirculation and pathological manifestations of microcirculation disturbance and summarize the research progress and clinic evaluation on the impacts of various vasoactive agents, including vasoconstrictor, vasodilator agents and some positive inotropic agents, on shock treatment and microcirculation regulation. Trend At present, few studies have confirmed the convincible and positive effect of vasoactive agents on microcirculation improvement. Nowadays, novel and ideal drugs aim at improving microcirculation are still under research and development. Microcirculation monitoring technologies are being explored to guide application of vasoactive agents and fluid resuscitation. The present “hemodynamic parameters-target therapy” should be replaced by “microcirculation parameters-target therapy” in shock treatment to rectify tissue oxygen dysmetabolism, protect organ function and improve the successful rate of shock treatment.