The authors present and discuss the current data concerning diagnosis, treatment and prophylaxis of fungal infections in prematurely delivered infants. On the basis of the results obtained from recent meta-analyses, randomized controlled trials and their own experiences, the authors propose guidelines regarding the diagnosis and treatment. The rationale for prophylaxis against fungal infections in very low birth weight infants is also suggested. The schedule of prophylaxis with fluconazole is based on ten years of their own clinical observations.