Candidemia presents several challenges to the intensive care unit (ICU) community. Recognition and treatment of this infection is frequently delayed, with dramatic clinical deterioration and death often preceding the detection of Candida in blood cultures. Identification of individual patients at the highest risk for developing candidemia remains an imperfect science; the role of antifungal therapy before culture diagnosis is yet to be fully defined in the ICU. The absence of well-established molecular techniques for early detection of candidemia hinders efforts to reduce the heavy clinical and economic impact of this infection. Echinocandins are the recommended antifungal drug class for the treatment of ICU candidemia.