The aim of this laboratory-based study is to report ICU-acquired candidemia incidence rate and the circulating Candida spp. in a university tertiary care hospital for the first time in Egypt. This study was conducted between January 2013 to December 2017 at the Ain Shams University Specialized Hospital located in Cairo. The incidence rate and species distribution as well as antifungal susceptibility testing of isolated Candida spp. against fluconazole, voriconazole, caspofungin, and micafungin were determined. During the study period, a total of 50 proven candidemia episodes were recorded. The incidence rate is 3.3 cases/1,000 ICU admission-year amounting to a burden of 33.33 cases/100,000 inhabitants-year (95% CI 32.97 – 33.70). Out of the 50 isolated Candida species, C. albicans accounted for (26%) while non-albicans species accounted for 74%. The rank order of Candida spp. isolated was C. krusei 14 (28%), C. albicans 13 (26%), C. parapsilosis 10 (20%), C. tropicalis 8 (16%), and C. glabrata 5 (10%). The antifungal susceptibility testing revealed that all isolated Candida spp. exhibited variable resistance rates to the four tested antifungal agents where low rates of resistant isolates were observed for caspofungin (24%) while the high rates were observed for fluconazole (50%). The results obtained indicated that the incidence rate of candidemia and the emergence ratio of non-albicans Candida spp. is the highest compared to neighboring countries in Middle East.