The distinction between Candida colonization of the urinary tract and infection is often blurred. Asymptomatic candiduria is particularly common in catheterized intensive care unit patients. To date, few studies have addressed the appropriate treatment regimens for candiduria. Fluconazole has become a mainstay of therapy; however, when to treat, whom to treat, and how long to treat are still largely unanswered questions. Asymptomatic nosocomial candiduria infrequently requires treatment intervention because morbidity is low and ascending infection and candidemia are rare complications. An understanding of the anatomic site of infection drives treatment decisions. More research is needed to define diagnostic criteria and therapeutic pathways. This review attempts to summarize the diagnosis and management of candiduria.