To conclude, VAP continues to be a major challenge to the critical care physicians in India and is a common nosocomial infection occurring in mechanically ventilated patients. Knowledge of the important risk factors predisposing to VAP may prove to be useful in implementing simple and effective preventive measures including non-invasive ventilation, precaution during emergency intubation, minimizing the occurrence of re-intubation, avoidance of tracheostomy as far as possible, and minimization of sedation.