Methicillin-resistant Staphylococcus aureus bacteremia in patients in intensive care units is associated with significant morbidity and mortality. Prompt clinical attention is essential to ensure good outcomes, including identification and management of the source of infection and any associated complications. Foreign-body sources of infection should be removed or replaced in the majority of cases, and debridement of infectious foci should be undertaken. Particular attention should be given to evaluation for the presence of cardiac involvement because inadequately managed S. aureus endocarditis is life threatening. Selection of an appropriate antibiotic regimen is also an essential factor for optimal management.