Background: Guidelines or similar publications are recommended conducts based on consensus between doctors, epidemiologists, researchers and health professionals at all to drive decision making on a theme of interest, including a medical specialty or clinical condition. In The Cochrane Library, the main ‘provider’ of systematic reviews in the world, it was possible to find only 13 systematic reviews referring to sepse, severe sepsis or septic shock in the title since 2001. In view of this, we are interested in quantifying the number of guidelines or similar publications on severe sepsis which used Cochrane systematic reviews (SRs) to construct their recommendations. Objectives: To evaluate the proportion of guidelines on severe sepsis referring to Cochrane SRs from 1994 to March 2008. Methods: A sensitive search strategy was used in PubMed to identify guidelines or similar publications involving severe sepsis, composed by the following terms and their synonymous: severe sepsis, health planning guidelines, guideline, guidelines, guidelines as topic, practice guidelines, consensus development conference NIH, clinical conference, consensus, and directive counseling. Results: The search strategy yielded 518 studies of which 47 had potential to be guidelines or similar publications on severe sepsis or septic shock by reading titles and abstracts; 38.29% (18/47) were ultimately a guideline or similar publication on severe sepsis or septic shock after scrutinizing full texts; 10.6% (5/47) are awaiting assessment. Only 22.2% (4/18) included Cochrane SRs. Conclusions: Despite the increased popularization of ‘systematic reviews’, including as a jargon among professionals of health sciences, in conjunction with the high prevalence of severe sepsis around the world (e.g., 2,857,476 cases in 10 years, specifically in the USA, and 14% of all ICUs admissions in Brazil), only 22% of guidelines or similar types of publications have truly used Cochrane SRs to guide the recommendations for this specific clinical condition. It seems that the main reasons for this result are the probable poorness of good research on sepsis and the low adhesion of its specialists to the evidence based medicine paradigm, which would limit the production of RCTs, Cochrane SRs and guidelines using them.