Sepsis is a major cause of emergency medicine department (EMD) admission. It is associated with high morbidity and mortality. The rapid identification of sepsis and initiation of treatment play critical roles in the optimal management of patients with bloodstream infections and their survival. In our study, we tried to find out the prevalence of positive blood culture in the emergency department and its role in identifying the severity and prognosis of sepsis. Methods 2-year prospective survey of 80 septic patients who were admitted to the EMD of a tertiary care centre in South India. Chi-square test was done to find the association between mortality and the blood culture. Results In our study population, the mean age was 56.99 ± 16.329 years. 59% of patients had severe sepsis and 41% developed septic shock. The mortality rate of patients admitted with severe sepsis and septic shock are 23.4% and 87.9% respectively. 45% of blood culture-positive cases had severe sepsis and 55% of cases had septic shock on admission to EMD. There is no statistically significant correlation between blood culture and severity of sepsis. (p = 0.238) Patients were followed up for 45 days. We did not find any statistically significant correlation between blood culture-positive cases and mortality. (p = 0.197)