Systemic sepsis is a growing global health challenge characterised by high morbidity and mortality, primarily driven by severe hypotension due to capillary leak and fluid sequestration. Initial management typically involves intravenous fluids and broad-spectrum antibiotics. When these interventions fail to restore adequate blood pressure, vasopressors such as noradrenaline are administered to induce vasoconstriction and maintain organ perfusion. However, vasopressor use can lead to peripheral ischaemia, resulting in severe complications including limb necrosis and, in extreme cases, amputation. Current Surviving Sepsis Campaign guidelines emphasise aggressive fluid resuscitation, yet this approach has been linked to increased incidence of multi-organ failure and mortality. This has prompted investigation into adjunctive therapies that improve haemodynamics without exacerbating ischaemic injury. Intermittent pneumatic compression (IPC) devices, widely used for venous thromboembolism prophylaxis, have emerged as a novel method to augment venous return and mobilise interstitial fluid, thereby improving circulatory volume and blood pressure. We present the case of a 33-year-old male admitted with severe sepsis and profound hypotension following orthopaedic surgery for a fractured lower leg initially treated in Vietnam. Despite high-dose noradrenaline and dobutamine infusions, ischaemic changes developed in his fingers and toes by day three. IPC devices were applied to his lower limbs, resulting in rapid haemodynamic improvement that allowed vasopressor discontinuation within 48 hours. Ischaemic changes fully resolved within four days without progression to tissue necrosis. This case illustrates the potential of pneumatic compression therapy as a valuable adjunct in septic shock management. By facilitating interstitial fluid mobilisation and improving microcirculation, IPC devices may reduce vasopressor requirements and prevent devastating ischaemic complications.