Hospitals are intended to heal the sick; but they are also sources of infection. Ironically, the advances in medicine are partly responsible for the fact that today; hospital infections are the leading cause of death worldwide. Newer technology and latest surgical and medical diagnostic methods and treatment procedures have increased the number of invasive techniques leading to higher chances of nosocomial infection. Pneumonia is the leading cause of death due to nosocomial infections. Intubation & mechanical ventilation greatly increases the risk for ventilator-associated pneumonia (VAP). In developing country like India, such hospital-acquired infections have a significant impact on patient's morbidity, mortality, hospital stay and on financial concerns of the patient, hospital and community. The present investigation was aimed to determine the incidence of ventilator associated pneumonia in the neurosurgery intensive care unit of a tertiary care centre and to determine the risk factors of ventilator associated pneumonia. A total of 30 samples belonging to the age group of 15 to 75 years who where on mechanical ventilator for more than 48 hours in the neurosurgery intensive care unit of a tertiary care centre were selected using convenience sampling. The incidence of VAP was estimated to be 30%. The risk factors identified for the development of VAP was found to be combined head and cervical spine injury (P=0.001), associated injuries (P=0.035), additional surgeries (P=0.025), nasogastric feeding (P=0.001), intake of immuno suppressive drugs (P=0.004), pre operative antibiotics (p=0.000) and duration of mechanical ventilation >5 days (P=0.000). The mortality among patients with VAP was found to be higher than patients without VAP (88.9% than non VAP patients).