Coagulation disorders are a key link in the process of endotoxic shock-induced microcirculation dysfunction and sepsis, which is closely related to organ injury and mortality of patients. Based on the three aspects of “reducing blood hypercoagulability, supplementing coagulation factors, and inhibiting fibrinolytic hyperactivity”, this paper reviews the beneficial effects of preventive and therapeutic measures to restore coagulation homeostasis and improve the prognosis and reduce the mortality of endotoxin shock or sepsis.