We studied the epidemiology of nosocomial candidaemia by assessing the incidence and outcome of illness and causative species in a large Finnish tertiary care centre during 1987-2004. A total of 364 episodes were observed; annual incidence varied between 0.26 per 10,000 patient-d in 2000 and 0.59 in 1989. The most common species were C. albicans (65%), C. parapsilosis (13%), and C. glabrata (9%). The proportion of C. albicans decreased from 71% during 1987-1992 to 58% during 1999-2004, and C. glabrata increased from 3% to 14%, respectively. The proportion of intensive care patients increased from 27% during 1987-1992 to 44% by 1999-2004, associated with neonates and surgical patients. The 1-month case fatality ranged from 30% to 33%. Nosocomial candidaemias did not increase, but the distribution of Candida spp. changed. Mortality remained high. The observed changes may reflect differences in prevention strategies that need to be explored for further improvements in prevention.