〔Abstract〕 Objective To evaluate the value of thrombelastogram (TEG) in monitoring heparin anticoagulation in patients with sepsis after continuous renal replacement therapy (CRRT). Methods A total of 80 sepsis patients treated with CRRT from March 2018 to March 2021 in the Second Affiliated Hospital of Xiamen Medical College were enrolled. They were divided by lottery into control group [monitoring activated partial thromboplastin time (APTT), 40 cases] and observation group (using TEG on the basis of the control group, 40 cases). The incidence of bleeding events, the dosage of heparin and the use time of filter were analyzed and compared between the two groups. Results The incidence of bleeding events in the observation group was 5.0 % (2/40), which was not statistically significant compared with 15.0 % in the control group (P > 0.05). There was no significant difference in heparin dosage between the observation group and the control group (P > 0.05). The filter use time in the observation group was longer than that in the control group, and the difference was statistically significant (P < 0.05). Conclusion TEG is a rapid and effective monitoring measure, which can provide monitoring means for CRRT anticoagulation in patients with sepsis, ensure the smooth treatment of CRRT in patients with sepsis, and improve the prognosis of patients.