Aim: The study aims to analyze the changing spectrum of candidiasis in ICU patients, with a focus on the shift from Candida albicans to non-albicans Candida (NAC) species, their antifungal susceptibility patterns, and associated risk factors. Materials and Methods: This prospective observational study was conducted in the Department of Microbiology at Gouri Devi Institute of Medical Sciences & Hospital, Durgapur (W.B). A total of 100 ICU patients clinically suspected of candidiasis were included. Clinical specimens, including blood, urine, sputum, and endotracheal aspirates, were collected and processed using standard microbiological methods. Species identification was performed using germ tube tests, chromogenic agar, and automated systems like VITEK 2. Antifungal susceptibility testing was conducted according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: Among the 100 ICU patients studied, the mean age was 55.3 ± 12.5 years, with a male predominance (60% males, 40% females). The most commonly isolated species was Candida albicans (50%), followed by Candida glabrata (20%), Candida tropicalis (15%), Candida parapsilosis (10%), and Candida krusei (5%). Blood cultures were the most frequent source of Candida isolates (40%), followed by urine (30%), endotracheal aspirates (15%), sputum (10%), and other body fluids (5%). Antifungal susceptibility testing showed that Candida albicans had 70% fluconazole susceptibility, whereas NAC species showed only 40% susceptibility. Voriconazole susceptibility was 85% in C. albicans and 70% in NAC species. Amphotericin B and caspofungin exhibited higher efficacy, with susceptibility rates of 95% and 90%, respectively, for C. albicans and 80% and 85% for NAC species. The most common risk factor was broad-spectrum antibiotic use (75%), followed by prolonged ICU stay (>7 days) (65%), use of central venous catheters (60%), mechanical ventilation (50%), and diabetes mellitus (40%). Conclusion: The study highlights a significant shift from Candida albicans to non-albicans Candida species in ICU patients, with NAC species exhibiting higher resistance to fluconazole. Routine species identification and antifungal susceptibility testing are crucial for optimizing therapy. The findings emphasize the need for early diagnosis, targeted antifungal treatment, and stringent infection control measures to mitigate the risk of candidiasis in ICU settings.