The study reexamines the attributable mortality of nosocomial candidemia 15 years after a previous retrospective cohort study at the University of Iowa Hospitals and Clinics (UIHC) reported an attributable mortality of 38%. Between July 1, 1997, and June 30, 2001, 108 matched pairs of case and control patients were analyzed. The crude mortality among case patients was 61% (66 of 108), compared to 12% (13 of 108) among controls, resulting in an attributable mortality of 49% (95% CI, 38%–60%). The study found that nosocomial candidemia remains associated with extremely high crude and attributable mortality, much higher than expected from underlying diseases alone. The high mortality rates are consistent with previous studies and are not significantly influenced by changes in antifungal therapy or resistance patterns. The authors emphasize the need for improved prevention strategies to reduce the burden of nosocomial candidemia.The study reexamines the attributable mortality of nosocomial candidemia 15 years after a previous retrospective cohort study at the University of Iowa Hospitals and Clinics (UIHC) reported an attributable mortality of 38%. Between July 1, 1997, and June 30, 2001, 108 matched pairs of case and control patients were analyzed. The crude mortality among case patients was 61% (66 of 108), compared to 12% (13 of 108) among controls, resulting in an attributable mortality of 49% (95% CI, 38%–60%). The study found that nosocomial candidemia remains associated with extremely high crude and attributable mortality, much higher than expected from underlying diseases alone. The high mortality rates are consistent with previous studies and are not significantly influenced by changes in antifungal therapy or resistance patterns. The authors emphasize the need for improved prevention strategies to reduce the burden of nosocomial candidemia.