Pseudomonas aeruginosa bacteremia remains associated with considerable mortality despite recent antibiotic advances. To evaluate mortality risk factors and the influence of appropriate antimicrobial therapy on patient outcome, 56 cases of P. aeruginosa bacteremia were identified, and the pertinent data were analyzed. The mean age of the 56 subjects was 67.0 ± 17.9 years, and 76.8% (n = 43) were men. The most common underlying disease was malignancy (n = 24; 42.9%). Polymicrobial bacteremia was acquired by 23% (n = 13) of the patients, with 55% (n = 31) of the infections nosocomial. Urinary and respiratory tract infections were the 2 main bacteremia origins. The overall 30-day mortality rate was 35.7%. Of the 20 fatalities, 80% died within the first 1 week. In this study, appropriate antimicrobial therapy for P. aeruginosa bacteremia was the principal determinant of clinical outcome. On encountering possible P. aeruginosa bacteremia, physicians are encouraged to prescribe antipseudomonal antibiotics promptly and empirically, either as combination therapy or monotherapy, because of its rapidly deteriorating clinical course.