Infections in critically ill patients are one of the leading causes of death on a global scale. A severe infection can lead to sepsis, a life-threatening organ dysfunction resulting from a dysregulated host response to infections1. Sepsis is a heterogeneous disease state with various etiologies, in the clinical course of which infections, host comorbidities, and unique genetic conditions play an important role2. Therefore, it is very important to identify risk factors for infection and sepsis1,2. Osteoporosis, characterized by a low bone mineral density (BMD), is a chronic progressive disease and constitutes an important public health problem characterized by microarchitectural bone deterioration and skeletal fragility, leading to fractures. A low BMD greatly increases a person's risk of experiencing a fracture, with this risk being at least 40% for women and 15-30% for men with osteoporosis3. In recent years, quantitative measurements made using computed tomography (CT) from various tissues, such as the liver (e.g., fat quantification for steatosis), vasculature (e.g., aortic and coronary artery calcification scoring for atherosclerosis), and fat (e.g., size and attenuation for adiposity), have been investigated in certain clinical areas4. In addition, the most widely studied biomarkers in the musculoskeletal system are determined from bones (e.g., attenuation for osteoporosis) and muscles (e.g., size and attenuation for sarcopenia)4. Most recently, feasibility studies supported the use of vertebral attenuation in the assessment of BMD loss for osteoporosis screening based on low bone mass and quality, in which increased bone fragility and fracture risk were observed5,6. Low BMD values have also been shown as a critical prognostic factor in many benign and malignant diseases, such as cerebrovascular disease, coronary artery disease, chronic obstructive pulmonary disease, and breast cancer. However, there are limited studies investigating the effect of a low BMD on the prognosis of patients with sepsis in the intensive care unit. The current study aimed to investigate the effect of vertebral bone density on the prognosis and clinical outcomes of patients diagnosed with sepsis in the intensive care unit.