The expression of microRNA-23b in peripheral blood leukocytes of patients with sepsis was investigated to assess the correlations with leukocyte, E-selectin, ICAM-1 and disease severity. The expression of microRNA-23b in peripheral blood leukocytes from 87 patients with sepsis, 50 patients with systemic inflammatory response syndrome (SIRS) and 50 normal controls were measured by reverse transcription-quantitative PCR (RT-qPCR), and stability of microRNA-23b was evaluated. Enzyme-linked immunosorbent assay (ELISA) was used to detect E-selectin and ICAM-1. Sequential organ failure assessment (SOFA) scoring system was used to assess the severity of sepsis patients. Correlation analysis was performed between microRNA-23b and the total number of white blood cells (WBC), E-selectin, ICAM-1, and SOFA scores. Compared with the normal control group, the expression level of microRNA-23b in the sepsis group was significantly decreased (P<0.05), andWBCandE-selectin were significantly increased (P<0.05). ICAM-1 level in the sepsis and the SIRS groups was significantly higher than that in the control group (P<0.05), and it is also higher in the sepsis group than in the SIRS group. In the sepsis group, the expression level of microRNA-23b in the death group was significantly lower than that in the survivor group (P<0.05), while the level of E-selectin, ICAM-1, and SOFA scores were significantly higher in the death group than in the survivor group (P<0.05), while there was no significant difference in WBC between the groups (P>0.05). The expression level of microRNA-23b in patients with sepsis was significantly negatively correlated with SOFA scores, E-selectin, and ICAM-1 (r=-0.633, -0.585, and -0.439, respectively, P<0.05). The expression of microRNA-23b in peripheral blood of patients with sepsis is related to the manifestation of the inflammatory state, and can be used to judge the severity and prognosis of patients with this disease.