Background: Fungal sepsis in neonates is third most common blood stream infections in ICUs. The changing epidemiology to non-albicans Candida is grossly evident. Azole resistance is on rise, next alternative are Echinocandins.Objective: To study the prevalence of Candidemia in high-risk neonates of NICU and to study Caspofungin (Echinocandin) antifungal susceptibility in Fluconazole resistant Candida isolates by E test / MIC test strip method.Material and Methods: The blood sample collected from all high-risk neonates admitted during the study period in NICU of Dr. Prabhakar kore charitable hospital, Belagavi during study period, were included in the study. All the samples were processed according to the standard operating procedures of Mycology, conventionally.Results: A total of 230 Blood samples collected from NICU from the high-risk neonates with suspected sepsis, who were admitted in the study period and were processed and were evaluated.53.97 (n= 34) isolates are resistant to Fluconazole and 76.19 (n=48) are resistant to Voriconazole. By E-strip method 20.63 (n=13) were resistant to Caspofungin.Conclusion: Prophylactic usage of Fluconazole as an antifungal drug is now questionable as Fluconazole resistance is on rise. Echinocandins are the only next alternative. Strict infection control strategies, appropriate preventive, and therapeutic measures should be implemented.