The objective: to investigate the efficacy and safety of terlipressin when it is used as an additional vasopressor in septic shock. Subjects: A single-center, observational, retrospective-prospective study of the efficacy and safety of combined therapy of septic shock with norepinephrine and terlipressin versus monotherapy with norepinephrine was conducted. Results. The use of terlipressin made it possible to reduce the average daily need for noradrenaline in patients with septic shock from 0.68 μg · kg · min in the control group to 0.55 μg · kg · min in the study group (p = 0.015) and reduce the duration of vasopressor support from 8 days [6.0-11.0] to 6 days [5.0-8.0] in the study group (p = 0.023). The use of terlipressin did not reduce the need for mechanical ventilation, but it did reduce the duration of ventilation. The number of days free from mechanical ventilation in patients in the control group was 6.0 [1.0-18.0], in the study group - 16.0 [2.0-22.0], (p = 0.039). Conclusion. The use of terlipressin as a supplement to norepinephrine is an effective and relatively safe treatment for hypotension in refractory septic shock. -1 -1 -1 -1