Adequate resuscitation of shock early in the Emergency Department (ED) is essential to ensure improved patients’ outcome. The conventional end-points of resuscitation used are inadequate to determine systemic perfusion and oxygenation. Serum lactate is a more reliable endpoint of resuscitation. This study examines the use of serum lactate at various points of resuscitation in ED and their association with patients’ thirty-days survival time. Results of this study shall add to our understanding of the complex physiology of shock and its clinical relevance. Clinicians and scientists alike will undoubtedly benefit from the result in such a way that it will change the way we resuscitate critically ill patients. Hopefully we will be nearer to the truth in our endeavor to search for the most reliable parameter of shock during resuscitation.