Abstract: Circulatory monitoring is of great significance for early diagnosis and disease assessment. The recently proposed "pre-shock" is an independent clinical state between sepsis and septic shock, determined based on mean arterial pressure and blood lactate levels. This concept has potential value in evaluating disease severity and predicting prognosis. Microcirculatory disorders often occur before systemic circulatory changes, serving as an early indicator of tissue hypoperfusion. Skin mottling score, capillary refill time, peripheral perfusion index and sublingual microcirculatory assessment are recognized as effective tools for evaluating tissue perfusion and predicting mortality risk. Sepsis can be classified into clinical subtypes with different pathophysiological mechanisms and mortality risks based on hemodynamic characteristics, offering a basis for precise treatment. Circulatory monitoring runs through the entire process of diagnosing sepsis, grading disease severity, predicting prognosis and guiding treatment. The integration of systemic and microcirculatory data holds significant clinical significance for enabling individualized management of sepsis.