Vasopressors and inotropes are a powerful group of drugs that are used in states of shock and tissue hypoperfusion. Vasopressors differ in their action from inotropes. All vasopressors and inotropes are usually administered via a large central vein. Hypotension, volume resuscitation, selection and titration, hemodynamic interactions, central line for infusion, tachyphylaxi and invasive arterial pressure line in the radial or femoralartery are the basic principles of inotropes and vasopressors. Phenylephrine, norepinephrine, ephedrine, epinephrine, dobutamine, dopamine, isoproterenol, noncatecholamine vasopressors and inotropes, vasopressin, terlipressin are the catecholamine vasopressors and inotropes. The main focus of this chapter is on mechanism of action of catecholamines, basic principles of inotropes and vasopressors, physiology of inotropes, pharmacology of individual agents, catecholamine vasopressors and inotropes, phosphodiesterase inhibitors, clinical evidence of inotropes and vasopressor use in different clinical study and inotropes for cardiogenic shock, congestive heart failure and postoperative support. Clinical uses hemodynamic goals in septic shock and acute respiratory distress syndrome is also discussed in this chapter.