Over the past decade, an increasing trend in vancomycin minimum inhibitory concentration (MIC) levels for methicillin resistant Staphylococcus aureus (MRSA) and methicillin-sensitive S. aureus has been reported. The phenomenon has been a topic of great interest in light of limited new and novel antimicrobial therapy in recent years. The goals of this study were to examine the relationship between high vs. low vancomycin MIC and patient outcomes, to assess the usage of vancomy- cin over time, and to determine whether an increase in vancomycin MIC had occurred among MRSA clinical isolates over time.