Aim: To assess the occurrence of Ventilator-Associated Pneumonia and identify the frequent microbiological pathogens associated with VAP. Materials and Methods: This prospective observational study aimed to evaluate the incidence of ventilator-associated pneumonia (VAP) and identify prevalent microbial pathogens in 100 patients admitted to the Intensive Care Unit (ICU) who required mechanical ventilation for more than 48 hours. Patients included in the study were aged 18 years and above, requiring mechanical ventilation for over 48 hours. Clinical parameters, including the duration of mechanical ventilation and use of antibiotics, were noted. Specimens were collected aseptically and transported to the microbiology laboratory, where pathogens were identified using standard culture techniques and biochemical tests. Antibiotic susceptibility was determined using the disk diffusion method as per Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: The incidence of VAP is summarized in Table 6. Out of 100 patients and a total of 1200 ventilator days, 30 cases of VAP were diagnosed, resulting in an incidence rate of 25.0 per 1000 ventilator days. This incidence rate aligns with reported ranges in the literature, emphasizing the need for vigilant infection control measures in the ICU to reduce VAP incidence.The duration of mechanical ventilation was longer in the VAP group (14.8 ± 3.9 days) compared to the Non-VAP group (9.6 ± 2.7 days), with a p-value of <0.01. The use of antibiotics was higher in the VAP group (83.33%) compared to the Non-VAP group (71.43%), although this was not statistically significant (p-value of 0.20). The new onset of fever was significantly more common in the VAP group (73.33%) compared to the Non-VAP group (21.43%) with a p-value of <0.01. Purulent tracheal secretions were also more prevalent in the VAP group (66.67%) compared to the Non-VAP group (17.14%) with a p-value of <0.01.Pseudomonas aeruginosa was the most common pathogen, found in 33.33% of the cases. Staphylococcus aureus (MRSA) was present in 23.33% of the cases, followed by Acinetobacter baumannii in 20.00%, Klebsiella pneumoniae in 13.33%, and Escherichia coli in 10.00%.Resistance to Carbapenems was observed in 60% of isolates, while 40% were susceptible. Cephalosporin resistance was found in 50% of isolates, with the remaining 50% being susceptible. Conclusion: Ventilator related pneumonia is a potentially fatal complication that occurs in individuals who are undergoing mechanical ventilation. Administering an early and suitable antibiotic treatment based on the probable microorganisms, and adjusting the dosage as needed, depending on the findings of microbiological cultures and the clinical response of patients, is crucial for effectively managing Ventilator-Associated Pneumonia (VAP).