Early identification of sepsis is essential for initiating appropriate treatment and preventing mortality. In this retrospective study, researchers used clinical data to estimate the incidence of sepsis over time at 409 academic, community, and federal hospitals over a 6-year period. They found that the incidence of sepsis remained stable during this time. Although inpatient mortality due to sepsis declined somewhat, there was no change in the combined outcome of death or discharge to hospice. In contrast, analysis of claims-based data suggests a significant increase in the incidence of sepsis over time as well as a marked decrease in sepsis mortality and death or discharge to hospice. The authors conclude that analysis of clinical data may provide a better understanding of sepsis trends. The accompanying editorial highlights challenges associated with measuring the sepsis incidence and mortality.