Background: Sepsis is a life-threatening condition characterized by dysregulated host response to infection leading to organ dysfunction. Among the organs affected, the kidneys are particularly vulnerable, and acute kidney injury (AKI) is a frequent complication in septic patients. Sepsis-associated AKI significantly increases morbidity, mortality, length of hospital stay, and healthcare costs. Early recognition and timely management are essential for improving outcomes. The present study evaluates the incidence, clinical profile, and outcomes of acute kidney injury in patients with sepsis admitted to a tertiary care center. Materials and Methods: A prospective observational study was conducted among patients diagnosed with sepsis admitted to the intensive care unit and medical wards of a tertiary care hospital. Patients fulfilling the diagnostic criteria for sepsis were included and monitored for development of AKI using the KDIGO classification. Demographic data, laboratory investigations, hemodynamic parameters, and outcomes were recorded and analyzed. Results: Among 120 patients with sepsis included in the study, 54 (45%) developed acute kidney injury. AKI was more common in elderly patients and those with comorbidities such as diabetes and hypertension. Patients with septic shock had a significantly higher incidence of AKI. Increased serum creatinine, reduced urine output, and higher inflammatory markers were associated with severe AKI. Mortality was significantly higher among patients with AKI compared to those without AKI. Conclusion: Acute kidney injury is a common and serious complication of sepsis associated with increased mortality and prolonged hospitalization. Early identification of risk factors, strict monitoring of renal function, and timely intervention are crucial to reduce adverse outcomes in septic patients.