This chapter provides an overview of endogenous fungal infections of the eye. It is important to keep endogenous endophthalmitis as an important differential diagnosis in patients who show progressive intraocular inflammation. It is a serious, potentially vision threatening infection of the ocular tissue and occurs as a result of haematogenous spread of the infective organisms to the eye that cross the blood retinal barrier and set up infection in the eye, hence also called ‘Metastatic endophthalmitis’. It can be bacterial or fungal in origin and is termed as ‘Endogenous bacterial endophthalmitis’ and ‘Endogenous fungal endophthalmitis’ respectively. Endogenous endophthalmitis constitutes nearly 2-8% of all cases of infective endophthalmitis of which nearly 35-65% cases are fungal in origin. Fungal endophthalmitis typically occurs in immunocompromised patients although it has been reported in healthy individuals as well. Suppression of the host-immune system allows normally ubiquitous saprophytic fungi to manifest with severe vision threatening ocular involvement. The common fungi which have been implicated include Candida and Aspergillus, and occasionally Histoplasma, Coccidioidomycosis, Cryptococcus, Fusarium, Blastomyces, Sporothrix and Mucormycosis. Patients may present with redness, floaters, and decreased vision. Very often the lesions in Candida endophthalmitis are present in the retinal periphery and hence extensive disease may be present without causing symptoms. Routine fundoscopy to detect vitreous fluff balls may be the first indication of an invasive candidiasis in chronically ill patients. The chorioretinitis lesions may be bilateral and multiple in nearly half of the cases. Endogenous Aspergillus endophthalmitis on the other hand is more fulminant than Candida infection. Seen in the setting of solid organ transplant or cardiac valvular surgery, these infections carry high mortality rates because of cardiac and cerebral involvement. Aspergillus abscesses are large and typically spread in the subretinal pigment epithelium space. The primary inflammatory foci usually occurs in the inner choroid but rarely may be confined to the retina. Ultrasonography is useful in patients with obscured fundal view and provides information on the extent of vitreal and scleral involvement, retinochoroidal thickening underlying choroidal abscess and retinal detachment.