The presence of Candida species in the urine is frequent among hospitalized patients. It represents a major challenge to the physician because it is unclear whether candiduria represents colonization or infection, whether the bladder or the kidney is involved in infection, or whether it represents a surrogate marker for systemic infection. This picture is more complicated because there are few prospective studies addressing the issue of when and how to treat a patient with candiduria. Strategies for management are based on the presence or absence of other features such as anatomic genitourinary abnormalities, renal transplant, and fever. If treatment is considered, fluconazole is the drug of choice, provided the agent is not Candida krusei or Candida glabrata.