Catheter related septic central venous thrombosis (CR-SCVT) is an uncommon but serious complication related to central venous catheter use. Prolonged sepsis, late detection of the right diagnosis, difficult, long and costly treatment (and its own complications) threaten patients with further, potentially lethal complications. By the patients with an evidence of catheter sepsis, which persists despite targeted antibiotic therapy, it is important to think of this possible complication. Diagnosis can be determined by a combination of clinical, laboratory, microbiological and imaging techniques, from which is transesophageal echocardiography the most useful diagnostic test. Treatment of CR-SCVT consists of long-term targeted antibiotic therapy, the role of anticoagulation is not clearly solved. The article presents case studies of four patients diagnosed and treated in our clinic for infected thrombus in the superior vena cava and right atrium in relation with a central venous catheter. It also compares our diagnostic and therapeutic strategies with the similar cases described in literature.