ABSTRACT Background: The Sequential Organ Failure Assessment (SOFA) Score has been developed, to describe the degree of organ dysfunction/failure over time in groups of patients. Present study was aimed to evaluate the SOFA score at 0 and 72 hrs and predict the outcome in patients admitted in sepsis through emergency department. Material and Methods: Present study was single-center, prospective, observational study, conducted in patients age more than 18 years, both gender, with suspected infection, had any 2 of the q SOFA criteria (Altered mental status OR Respiratory rate >22 OR Systolic BP <= 100mmhg) & SOFA scoring more than 2, relatives willing to participate in present study. Results: In present study, 50 patients were studied. Mean age was 53.26 ± 11.619. Of the 50 subjects who were enrolled in our study 32 (64%) were male and 18(36%) were female. Final outcome of the study was 46% dead and 54% alive. Mean length of stay in hospital was 7.26 ± 3.82 days. SOFA score at admission, scores 4-5 have highest frequency and 2-3 has the lowest frequency of occurrence. As the SOFA score increases the mortality increases and as the SOFA score decreases mortality decreases. SOFA score at 72 hrs, when SOFA score is >11 it has a 78% mortality. Initial score from 2-7 had a mortality rate of 12.5%, 8-11 had a mortality rate of 60% and above 11 had a mortality rate >91%. Delta SOFA with mortality when the score is > 2 there is a mortality of 20 persons and when the score is <-2 there is less mortality. Conclusion: The SOFA score demonstrated fair to good accuracy for predicting in-hospital mortality when applied to patients with severe sepsis with evidence of hypo-perfusion at the time of ED presentation.