Adipocyte lipolysis and its adrenergic control were studied in vitro from normal patients and those with trauma and sepsis. The adrenergic receptors were studied in terms of their responsiveness, a measure of the postreceptor mechanism, and their sensitivity, a measure of the receptor number or affinity. With early trauma, beta-adrenergic responsiveness and receptor number were significantly decreased. This is desensitization of the beta-receptors with down regulation and indicates increased in vivo lipolysis in early injury. After 4 days these changes had returned to normal. Early sepsis resulted in a significant increase in beta- and alpha-receptor responsiveness with beta-upregulation. This indicated hypersensitivity of the adipocyte adrenergic receptors and suggests the presence of an in vivo block of the adrenergic receptors in early sepsis. This would decrease adipocyte lipolysis. After 4 days there was a decrease in beta-receptor responsiveness in the patients with sepsis, indicating that the adrenergic receptor block was no longer present and adipocyte adrenergic stimulated lipolysis was increased.