Antifungal agents such as amphotericin-B and azoles are commonly used for treatment of oral candidiasis. However, due to the toxicity and emergence of resistant Candida species, there is a desire for therapy that is effective while less toxic. We hypothesize that berberine, a natural plant alkaloid, inhibits growth of Candida species and exhibits synergism with antifungal azoles. Objectives: To investigate the in vitro growth inhibitory effect of berberine alone and in combination with antifungal azoles against Candida species. Methods: Candida . albicans, C. glarbata, C. kefir, C. krusei. C. parapsiolis and C. tropicalis were employed in this study. Minimum inhibitory concentrations (MICs) of BBr, amphotericin-B, fluconazole (FCZ), and miconazole (MCZ) against test species were determined by microdilution method in 96-well microtiter plates. The effect of BBr (30 mg) in combination with FCZ (10 mg) or MCZ (10 mg) were examined using disk diffusion in agar and the checkerboard assay (synergism, FICI <0.5; or antagonism, FICI >4). Cell viability after 12 hr exposure to BBr (15 mg/ml) and MCZ (1 mg/ml) alone or in combination was also determined. Results: Berberine inhibited the growth of Candida species (MICs 0.98 - 31.25 mg/ml) with susceptibility rankings of C. krusei > C. tropicalis > C. kefir > C. parapsiolis > C. glarbata and C. albicans. In most cases, the growth inhibition zones in agar of BBr/MCZ combination (11-28 mm) were larger than respective agents alone (BBr, 0-18 mm; MCZ, 6-22 mm). Synergism against C. albicans was observed between BBr and FCZ (FICI, 0.25) or BBr and MCZ (FICI, 0.27). Compared to the test agent alone at 12 h time point, BBr/MCZ combination reduced viability by 2 log10 CFU/mL. Conclusion: Berberine not only exerts anti-candidal activity but also exhibits in vitro synergism against Candida species when combined with fluconzole or miconazole. Supported by UIC college of Dentistry.