【Abstract】 High capillary permeability is an essential pathophysiological alteration in sepsis, which can cause severe microcirculatory insufficiency and tissue hypoxia. As we know, increased capillary permeability results in multiple organ damage and dysfunction. This review summarizes the potential pathogenesis and therapeutic advances of increased capillary permeability in sepsis. It shows that endothelial cell death, degradation of the surface glycocalyx, and disruption of pericyte‑endothelial cell interactions increase capillary permeability through specific signaling pathways. This introduction demonstrates the effects of signaling pathways on modulating capillary hyperpermeability. Studying the targeted activation of various endothelial pathways in capillary hyperpermeability in sepsis plays a critical role in its diagnosis and treatment. Further exploration is still needed to provide a theoretical basis and reference for clinical practice.