The goal of critical care support is to prevent premature death and to reduce the morbidity and suffering of the critically ill patients by intensive therapy for reversible illness within optimal timeframe. Undesirable quality of critical care service in Korean hospitals necessitates system-level change in the organization of critical care. The causes of critical care system failure are multifactorial, including unreasonable critical care reimbursement system, shortage of critical care professionals, and unacceptable level of legal standard for the critical care delivery system. The Korean Society of Critical Care Medicine (KSCCM), which was established in 1980, has been trying to improve critical care delivery system. The Society believes that improving ICU care can be achieved by standardizing the critical care initiated by dedicated full-time critical care physicians. To achieve this goal, the Society has attempted to include the critical care specialty as a part of our medical society during the past five years. On April 15th, 2008, the Society established a critical care specialty under the endorsement of the Korean Academy of Medical Societies. The Society believes that implementation of the critical care specialty and the core critical care education and training system can significantly enhance the quality of critical care and patient outcomes in Korean medical institutions. In order to create the high-quality critical care through the successful critical care team approach, we should reform the present critical care delivery system, and re-prioritize medical resources together with relevant legal support. For this, a long-term task force team consisting of all involved stakeholders including policy makers should be operated. The task force team has to play a central authority to implement and regulate the enhanced critical care system effectively to Korean hospitals. The reformation of critical care system should not be delayed, since intensive care unit is the last resort for the critically ill patients.