APROCCHSS examined the effect of hydrocortisone plus fludrocortisone in adults with septic shock. In this multicentre, double-blind trial, patients received the corticosteroid combination or placebo as part of a factorial design. The primary outcome was 90-day all-cause mortality. The combination treatment was associated with lower 90-day mortality than placebo, as well as more days alive and free of vasopressors and mechanical ventilation in several analyses. Hyperglycaemia was more frequent with corticosteroid treatment. The study is important because it demonstrated that not all corticosteroid strategies produce identical clinical effects. Compared with the ADRENAL trial, which tested hydrocortisone alone, APROCCHSS raised the possibility that mineralocorticoid activity may influence outcomes in selected patients with septic shock. At the same time, interpretation should remain grounded in the totality of corticosteroid evidence rather than in a single positive trial. The most useful bedside message is that corticosteroids may have a role in vasopressor-dependent shock, but the expected benefit is mainly related to haemodynamic recovery and, depending on regimen and population, possibly mortality. Clinicians should also account for glucose control, muscle weakness and infection-related complications when initiating therapy.