Candida albicans is generally considered to be susceptible, in vivo, to fluconazole. In the population infected with human immunodeficiency virus, recurrent bouts of oral and esophageal candidiasis have led to increasing use of fluconazole for long-term prophylaxis. With prolonged therapy, the issue of developing resistance emerges. We report a case of fluconazole-resistant C albicans esophagitis that developed after fluconazole was used for more than 600 days.