This document provides recommendations for treating pediatric patients with severe sepsis or septic shock. It covers initial resuscitation efforts, administration of antibiotics and source control, fluid resuscitation, use of inotropes and vasopressors, extracorporeal membrane oxygenation, corticosteroids, blood products, mechanical ventilation, sedation, glycemic control, renal replacement therapy, nutrition, and other topics. The recommendations generally aim to stabilize circulation and oxygen delivery, treat infection with antibiotics, and support organ functions. Grades are provided to indicate the strength of evidence for each recommendation.