OBJECTIVE To explore the effects of fluid resuscitation on adhesion molecule and hemodynamics in patients with severe sepsis. METHODS Thirty-eight patients with severe sepsis were randomly divided into 2 groups: rapid fluid resuscitation group and general treatment group. Before and after fluid resuscitation, heart rate (HR), mean arterial pressure (MAP), central venous pressure (CVP), lactic acid content, plasma P-selection and intercellular adhesion molecule-1 (ICAM-1) contents were determined. RESULTS There were no statistically significant differences in sex, age, resuscitation time and acute physiology and chronic health evaluation II (APACHE II) score between the two groups. Compared with general treatment group, more liquid volume but less aramine dosage were used (both P<0.05), MAP and CVP were increased after fluid resuscitation in rapid fluid resuscitation group (all P<0.05). The expression of P-selection, HR, contents of ICAM-1 and lactic acid were decreased (all P<0.05), and all of those were better than those of before fluid resuscitation. CONCLUSIONS Early rapid fluid resuscitation can improve hemodynamics and decrease the expression of adhesion molecule to retard the development of sepsis.