Objective To observe the clinical effects of intensive insulin therapy in elderly patients with sepsis. Methods A total of 114 patients (>60 years) with sepsis were randomly divided into two groups,intensive insulin therapy group (n=59) and routine insulin therapy group (n=55). The blood glucose was controlled within 4.4-8.3 mmol/L in intensive insulin group,and 10.0-11.1 mmol/L in routine insulin therapy group. Other therapies were identical in two groups. The serum C-reactive protein (CRP) level,duration for antibiotic usage,hospital-acquired infection rate,amount of vasopressors used,incidence of acute renal failure requiring blood purification,28-day survival rate were recorded. Results In intensive insulin therapy group,the serum CRP level,duration for antibiotic usage,hospital-acquired infection rate,amount of vasopressors used,and incidence of acute renal failure requiring blood purification were significantly reduced,and 28-day survival rate was significantly elevated,compared with routine insulin therapy group. Conclusion For elderly patients with sepsis,early intensive insulin therapy can control blood glucose more effectively and timely,and can improve the clinical therapeutic effects.