Historically, yeasts and molds have been identified by their microscopy and macroscopy appearance, detection of specific antigens and metabolites, the results of biochemical testing, and the presence of species-specific gene sequences. These methods are either nonspecific or, in the case of gene sequencing, technically demanding, time-consuming, and expensive. Recent studies have demonstrated that matrix-assisted laser desorption/ionization (MALDI) time-of-flight (TOF) mass spectrometry (MS) is a rapid, simple, inexpensive, and accurate tool for the identification of a wide spectrum of bacteria and fungi. There are also promising reports that this technology can be used for subtyping organisms and for performing antifungal susceptibility tests. This article reviews the applications of MALDI-TOF MS for routine clinical microbiology testing.