Globally, bloodstream infections are among the most serious infections resulting in significant morbidity and mortality. While blood cultures remain the standard of care, they are slow and insensitive. Syndromic panels that allow for rapid identification of a broad range of pathogens and resistance markers from positive blood cultures have been a major advance and have enhanced antimicrobial stewardship interventions. Existing platforms are being expanded and a novel platform that uses ferrocene labeled probes and electrochemical analysis and voltammetry to detect targets has just been released. Matrix assisted laser desorption ionization time of flight mass spectrometry has also been used successfully to identify organisms in positive blood culture bottles. The first rapid phenotypic susceptibility testing platform from positive blood cultures became available two years ago. The use of these rapid methods, in combination with antimicrobial stewardship, has improved antibiotic utilization, both in terms of de-escalation and earlier time to appropriate therapy. However, while studies show decrease in length of hospital stay and reduced hospital costs, very few studies demonstrate a reduction in mortality. Direct from whole blood testing has the ability to decrease poor patient outcome and has been available in Europe and other areas for more than a decade. However, the available assays are either limited in the pathogens detected, are less sensitive than blood cultures, or have been commercial failures because of cumbersome and prohibitively expensive instrumentation. A variety of new technologies are in development, appear promising, and will also be discussed in this presentation. At the same time, novel biomarkers are being tested and exploited to better assess the patient who presents with sepsis.