Objective To evaluate the application value of metagenomics next generation sequencing(mNGS)in the detection of pathogens of patients with sepsis.Methods The clinical data of 118 patients with sepsis admitted to the Department of Critical Care Medicine of Shenzhen People′s Hospital from October 2017 to September 2019 were retrospectively analyzed.The pathogen detection rate and coverage of mNGS and traditional microbial culture of two detection methods in blood samples were compared,and the influence of the use of antibiotic before sampling on the detection of both was further analyzed.Results The pathogen detection rate of mNGS pathogens in blood samples was 35.59%,which was higher than 16.10% of traditional microbial culture(P＜0.05).The use of antibiotics before sampling had little effect on the detection rate of mNGS(37.9% vs.29.03%, P=0.374),but which significantly reduced the detection rate of microbial culture(9.19% vs. 35.48%, P=0.002).Using blood culture results as the gold standard for bacteremia,the sensitivity,specificity,and Youden index of mNGS were calculated to be 78.95%,72.73%,and 51.68%,respectively.Conclusion The application of mNGS technology can improve the detection rate and coverage of pathogens,and has high sensitivity and specificity,of which could provide a more valuable reference for early targeted anti-infective therapy in patients with sepsis.