Pseudomonas aeruginosa continues to be a leading cause of nosocomial bacteremia and other serious, often life-threatening infections. The incidence of P. aeruginosa infection appears to be increasing. The resilience of Pseudomonas in the hosptial environment, its endogenous virulence factors, and its current level of resistance to antimicrobials make it a formidable pathogen, particularly in a compromised host. Despite the availability of several effective antipseudomonal antibiotics, infections caused by this pathogen are still associated with significant morbidity and mortality. Early recognition and prompt intervention with appropriate antimicrobial agents are vital to successful management. Combination therapy with an aminoglycoside and an extended-spectrum penicillin or cephalosporin is recommended in the initial mangement of suspected or documented P. aeruginosa infections.