At the Sixth Wiggers Bernard Conference, a group of scientists from various fields discussed new findings relating to nitric oxide synthase inhibitor in shock, sepsis, and organ failure. This meeting was dedicated to the presentation and discussion of positive and negative findings related to the use of NOS inhibitors, the issue of specific and non-specific inhibitors and the role of nitric oxide-oxygen radical interactions. Both experimental and clinical data were presented in the trauma and sepsis field. With appropriate dosing and timing the use of NOS inhibitors seems to be beneficial at least in severe sepsis situations, but some inhibitors and overdosing can be potentially dangerous.