Abstract: Stress-induced hyperglycemia occurs frequently in Intensive Care Units (ICU). Intensive Insulin Therapy (IIT) may reduce mortality and morbidity in critically ill patients. The present study investigates the effect of normoglycemia on morbidity and mortality of medical and trauma critically ill patients at Mansoura Emergency Hospital, Egypt. A prospective study comparing 2 consecutive time periods before and after IIT protocol implementation: period I (conventional glycemic control) with target blood glucose level 120-180 mg dL-1 and period II (IIT group) with target blood glucose level 80 to 130 mg dL-1. One hundred patients were subjected to no protocol and other one hundred patients were subjected to IIT. Study endpoints were the incidences of sepsis, hospital deaths, durations of mechanical ventilation and hospital length of stay in the ICU or hospital. The number of the patients receiving IIT was significantly higher than conventional glycemic control (97 vs. 69%). Patients on IIT protocol received significantly larger mean insulin dose 45±15 vs. 16±10 unit day-1 with conventional control. The crude hospital mortality rates were 14% during conventional glycemic group vs. 10% during IIT group. Tight glycemic control with an average blood glucose value <150 mg dL-1 was associated with a decreased incidence of sepsis and mortality. Highest mortality was seen in patients older than 65 years of age with poor glycemic control. Severe hypoglycemia was recorded in 6% of IIT patients, as compared with 2% undergoing conventional control. Finally, normoglycemia with IIT is associated with decrease mortality and incidence of sepsis with no significant effect on the length of hospital stay or days on mechanical ventilation.