Major burns lead to a hypermetabolic response that is more dramatic than that observed in any other disease or injury. In addition, major burns increase the metabolic demands of the body and can lead to severe loss of body weight and increased risk of mortality. The hyper-metabolic response is accompanied by severe catabolism and a loss of lean body mass and by a progressive decline of host defenses, which results in impairment of the immunological response. The protective functions of intact skin are lost, leading to increased risk of infection and protein loss. Therefore, adequate and timely provision of nutritional support is an essential component of care of the critically ill burn patient. Nutrition therapy is also important in burn care from the early resuscitation phase until the end of rehabilitation. Careful assessment of the nutritional state of the burn patient is also important to reducing infection, recovery time, and long-term results. Nutritional therapy in severe burns has evidence-based specificities that contribute to improve clinical outcomes.