Introduction: Many head injury patients have reduced consciousness, are prone to aspiration of oral secretions, and are likely to develop pneumonia. Respiratory tract infection (RTI), especially pneumonia, is a very common disease in Neurosurgical Intensive Care Units (NSICU). Objective: To evaluate the microbial profile of head injury and stroke patients admitted to EMCH, Savar, Dhaka, Bangladesh. Methods: It was a retrospective study conducted at Enam Medical College & Hospital, Savar, Bangladesh from 2017-to 2021. A total of 46 patients admitted with a head injury and stroke patient were enrolled in this study. Data were collected using a structured questionnaire  containing all the variables of interest. Data were processed and analyzed with the help of the computer program SPSS for windows version 25. Results: This study shows 84.8% males and 15.2% females. The mean age was 42.54±18.09 years. Pathogens found in culture samples were tracheal aspirate C/S (54.3%), urine C/S (26.1%), catheter tip C/S (13%), and the tip of the ET tube C/S (4.3%). Main attributed pathogens were staph. aureus (47.8%), Klebsiella spp (37%), E. coli (32.6%), streptococcus (2.2%), acinetobacter SPP (2.2%) and pseudomonas SPP (2.2%).Conclusion: This study shows staph. aureus, Klebsiella spp, and  E. coli are the most common pathogen isolated.  Therefore, careful microbial profile and antibiotic susceptibility testing are necessary for the prevention of pathogens as well as an effective treatment.