Despite the widespread use of antifungals for prophylaxis, Candida bloodstream infection (BSI) remains the most frequent life-threatening fungal disease. From an analysis of multi-institutional surveys of Candida BSIs performed in Europe, including the large prospective survey by the European Confederation of Medical Mycology (2089 episodes from seven countries), a limited role of species with decreased susceptibility to azoles in causing BSIs and a low proportion of antifungal resistance was evident. Large prospective epidemiological surveys using common databases are needed to monitor trends in incidence and changes in species distribution, to identify new at-risk patients and to evaluate the impact of the introduction into the market of new antifungal agents.