Candidemia is a leading cause of nosocomial bloodstream infections, associated with high mortality and substantial healthcare costs. Management challenges primarily arise from diagnostic delays due to the limitations of conventional methods, along with the difficulty in optimizing antifungal regimens. This review provides a comprehensive analysis of these issues, beginning with an overview of the epidemiology, species distribution, and origins of candidemia. It then focuses on the need for improved diagnostic technologies and the importance of susceptibility-guided therapy in enhancing patient outcomes and combating resistance. The article assesses current diagnostic approaches, their limitations, and emerging technologies that may enhance detection performance. Therapeutic strategies are examined in detail, including empiric and targeted regimens, management of mixed infections, and host-drug interactions. Particular emphasis is placed on antifungal resistance and the potential of combination therapy. Advances in drug development are also highlighted, covering agents in clinical trials and compounds targeting novel fungal pathways. Finally, future directions are explored, such as the application of artificial intelligence in diagnostics, vaccine-based prophylaxis, and synergistic treatment strategies. By synthesizing recent progress, this review aims to support clinicians and researchers in addressing the evolving challenges of candidemia management.