The aim of the research. The aim of the study was to evaluate the efficiency of extracorporeal selective endotoxin adsorption in complex treatment of sepsis and septic shock in patients with surgical diseases, as well as in puerperas with obstetric complications or surgical problems. Material and Methods. This pilot retrospective-prospective study without formation of a control group included 36 patients with sepsis (7) and septic shock (29) against the background of surgical pathology and/or obstetric complications. The patients underwent 67 sessions of lipopolysaccharide sorption (LPS sorption) using Alteco LPS adsorbers and the number of perfusions from one to three. The efficacy of the procedure was evaluated clinically and in the laboratory with the determination of levels of C-reactive protein, procalcitonin, presepsin and endotoxin activity assay (EAA). Results. After one-three sessions of LPS sorption, the severity on the SOFA scale reliably decreased from 12 to 7 points (p=0.000) due to improvements in cardiovascular (p=0.000), respiratory (p=0.001) and neurological indicators (p=0.041). There was a significant decrease in the percentage of rod-shaped neutrophils, the level of procalcitonin and endotoxin activity (p=0.007, p=0.000, p=0.002). The mortality rate amounted to 17 out of 36 (47.2%). A direct positive correlation was found between the lethal outcome and the timing of LPS sorption (r=0.432, p=0.024), as well as the presence of septic shock (r=0.324, p=0.050). The later the procedure was performed, the more often lethal outcomes were noted, especially in septic shock. A direct positive dependence of mortality on the need for vasopressor support before and after the procedure was established (r=0.446, p=0.007; r=0.653, p=0.000). The initial levels of procalcitonin, presepsin and endotoxin activity were not considered to be statistically significant for predicting the results of extracorporeal selective sorption of endotoxin. Conclusion. LPS sorption in sepsis and septic shock in addition to complex treatment significantly reduces the severity of multiple organ failure on the SOFA scale by improving cardiovascular, respiratory, neurological parameters and leads to a significant decrease in the level of procalcitonin and endotoxin activity. The earlier the procedure of extracorporeal selective sorption of endotoxin was initiated, the less lethal outcomes occurred.