We provide a review of current literature of native valve Candida tropicalis endocarditis. A 41-year old man presented with C. tropicalis candidemia complicated by superior vena cava mass and right main pulmonary artery thrombus. The patient achieved clinical and microbiologic cure with AngioVac of the mass and echinocandin for six weeks. Long-term suppression was challenging given the C. tropicalis strain was resistant to fluconazole, voriconazole and posaconazole. Additional susceptibilities were obtained and he remained relapse-free at 12 months with isavuconazole.