Aim: To evaluate the role of microalbuminuria as a biomarker of sepsis in hospitalized patients. Materials and methods: Adult patients (>18 years) with ICU stays exceeding 24 hours were included, while those with anuria, macroscopic hematuria, chronic kidney disease, significant proteinuria, menstruation, or pregnancy were excluded. Ethical approval was obtained with a waiver of informed consent. Patient demographics, medical history, clinical classifications, and laboratory parameters, including cultures and administered antibiotics, were recorded at admission. APACHE II scores were calculated within the first 24 hours, and patients were followed for up to 28 days to assess ICU length of stay and mortality. Patients were classified into two groups: those without sepsis (no SIRS or SIRS due to non-infectious causes) and those with sepsis (SIRS with infection, including severe sepsis and septic shock). Patients who developed infections after 48 hours were not included in the sepsis group, as these were deemed nosocomial. Patients were assessed at admission and 24 hours later for signs of SIRS and infection, using clinical, laboratory, and radiological evidence. Data analysis was done using SSPS software. Results: Out of 50 patients, 52% (26) being male and 48% (24) female. The median age of the patients was 52.6 years, ranging from 45 to 70 years. The median APACHE II score was 12 (IQR: 11-21), and the median ICU stay was 5 days (IQR: 3-7). Among the patients, 64% (32) survived, while 36% (18) did not. Conclusion: Microalbuminuria is a potential biomarker for distinguishing sepsis and predicting ICU mortality. Elevated levels at admission indicate sepsis, while persistently high levels at 24 hours correlate with increased mortality. Lower APACHE II scores and shorter ICU stays in non-septic patients further support its prognostic value. However, larger studies are needed to confirm these findings and establish standardized cut-off values.