Candida albicans, and Aspergillus species are the most common of the many fungal organisms identified as causing IE. Fungal endocarditis arises in specific settings. Valve replacement cardiac surgery and IV drug abuse are major predispositions. The most frequent fungi causing PVE are C. albicans, Aspergillus species, and nonalbicans Candida species, whereas addiction-associated fungal IE is most commonly caused by nonalbicans, Candida species, particularly C. parapsilosis. Bulky vegetations, which embolize frequently, are common in fungal IE. Removal and careful microbiological evaluation of an embolic vegetation may provide an etiological diagnosis in fungal IE.