Sludge is defined as a slushy mass, deposit, or sediment. In vascular access ports (VAPs), it appears to be the buildup of clotted blood, blood components, drug and mineral precipitates or residues, and lipids that adhere to or reside in the internal path of the reservoir. Several studies note the presence of sludge as a risk factor for increased incidence of VAP-related bloodstream infections as well as higher occlusion rates. Overall, the occurrence of sludge in implanted vascular ports may increase patient-associated risks and costs to health care providers by as much as $40,000 per incident. Understanding the significance of these associated risks and costs may lead to solutions that save health care facilities money; better serve health care providers; and ultimately, improve patient outcomes.