Central line insertion is a very common procedure in critical care settings, and is associated with infectious complications such as local colonisation and bloodstream infection which leads to bacteremia and sepsis. Causative microorganisms are commonly missed on blood cultures, so that empiric therapy must be started in absence of a known pathogen. Diagnosis is based on clinical suspicion and microbiological confirmation by means of local and blood cultures (quantitative or semiquantiative). The mainstay of treatment is a combination of early antibiotic treatment and catheter removal with insertion at a new site. Prevention is the cornerstone of catheter-related infections. Multimodular programs (education, surveillance and quality management) and the sophistication of catheter-associated devices have shown benefit on CRBSI rate reduction. Strategies must be grouped into bundles. CRBSI reduction plans are part of the general ICU quality improvement plan. Team work is crucial to the construction and follow-up of the strategies aimed at reducing the infection rate in critically-ill patients.