A study examined the association between B-lines on lung ultrasound and adverse outcomes in patients with sepsis treated in a resource-limited emergency department. Out of 184 patients with sepsis, 56 patients (30.43%) had B-lines on lung ultrasound. Patients with B-lines had higher in-hospital mortality (16.07% vs. 4.68%), higher need for mechanical ventilation (39.28% vs. 7.03%), and longer hospital stay (median 11 days vs. 6 days) compared to patients without B-lines. Multivariate analysis confirmed that the presence of B-lines was associated with four times higher in-hospital mortality (adjusted odds ratio 4.6). The findings suggest that point-of-care lung ultrasound (POCUS) may aid in the early identification of patients with sepsis at higher risk for adverse outcomes, particularly in healthcare settings with limited advanced imaging capabilities.