Which is the preferred vasopressor in shock—dopamine or norepinephrine? The SOAP II trial compared the effects of dopamine and norepinephrine in patients with shock, evaluating their impact on mortality and adverse outcomes. This large, multicenter randomized controlled trial enrolled critically ill patients with shock and randomized them to receive either dopamine or norepinephrine as the primary vasopressor. The study revealed no improvement in survival with dopamine compared with norepinephrine in patients with shock. The most striking finding was the increase in the 28-day mortality with dopamine among patients with cardiogenic shock. Norepinephrine was associated fewer adverse events, including arrhythmias, compared to dopamine. The findings suggest that norepinephrine should be preferred over dopamine as the first-line vasopressor in the treatment of shock, particularly due to its more favorable safety profile.