Endogenous endophthalmitis of bacterial or fungal origin is a rare condition, accounting for 5 to 10% of all endophthalmitis cases. Different risk factors have been identified and ocular involvement is usually due to one or multiple systemic infectious abscesses with variable virulence. Clinical symptoms may initially mimic a panuveitis and will delay diagnostic confirmation. Ancillary tests will determine the infectious source and isolate the causative agent. Specific therapy is based on systemic and intravitreal antibiotics or antifungals associated with a pars plana vitrectomy in severe cases. Despite an aggressive therapeutic strategy, visual prognosis remains guarded. Education of ophthalmologists and infectious disease specialists may decrease diagnostic delay so that specific antimicrobial agents can be initiated promptly and thus avoid a permanent blindness.