Hemorrhagic shock generates a prolonged alteration of organ perfusion due to the decrease in oxygen delivery. Hemorrhagic shock is mainly due to three etiologies: traumatology, gastrointestinal bleeding and high risk surgery. If intensive cares are not rapidly performed, severe complications occur, as organ failure with a high mortality rate. Primary cares aim at restoring a perfusion pressure to prevent tissue hypoperfusion while waiting for the radical therapy of bleeding. Priority during initial treatment is to restore tissue perfusion and achieve haemostasis in vital functions. Fluid resuscitation and transfusion are common to every case of hemorrhagic shock but the strategy to localise the hemorrhage and stop the bleeding differs between the situations. Key factors in the management of hemorrhagic shock are the communication between surgical, anaesthetic, and critical care teams and the application of pathology.