The shock state which occurs as a complication of bacteremia due to gram-negative bacteria is a problem encountered in urological practice. The seriousness of the problem is reflected by the 82% mortality noted in the series herein reported. This type of shock is frequently precipitated by urological instrumentation and manipulation. The clinical features are sufficiently distinctive to permit early diagnosis. Prompt treatment, including appropriate antibiotics, pharmacological amounts of corticosteroid, and judicious use of vasopressor agent, favors survival.