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Background The crucial role cytokines play in the pathophysiology of sepsis is widely accepted. Infection stimulates the production of cytokines in various cell types. Tumor necrosis factor-alpha (TNF-a) is one of the most extensively investigated cytokines in experimental and clinical sepsis. Tumor necrosis factor-alpha has been shown to mediate lethality in experimental sepsis. Objective To evaluate for a possible correlation between TNF-a level and septic shock in children. Methods This cross-sectional study was conducted in Manado from June to September 2011. A total of 40 patients with a recent diagnosis of sepsis or septic shock were included. Plasma specimens were collected from subjects for measurement of TNF-a concentration. Logistic regression analysis was used to assess the correlation between TNF-a level and sepsis, as well as the probability of shock in children with sepsis, with P<0.05 as statistically significant. Results There was a strong positive correlation between TNF-a level and the probability of shock in children with sepsis (regression coefficient = 0. 78, P = 0.002). Conclusions There is a strong positive correlation between TNF-a level with the probability of shock in children with sepsis. Higher plasma level ofTNF-a is associated with higher probability of septic shock.