Background: Hospital acquired infections continue to be an important cause of morbidity and mortality among hospitalized patients. Hospital acquired pneumonia (HAP) results in a significant increase in the cost of care of hospitalized patients. Its development prolongs a patient's stay in the Intensive Care Unit (ICU). Accurate information concerning the clinical profile of HAP is lacking in South India. This study was conducted prospectively to evaluate the clinical profile of HAP in ICU patients. Methods: This prospective study was conducted over a period of one year among 2454 patients admitted in IMCU of Coimbatore Medical College & Hospital, Tamil Nadu. The specimens' sputum, bronchoscopic alveolar lavage (BAL) and endotracheal aspirate (ETA) were collected for microbiological confirmation and processed using standard laboratory techniques. Results: Out of 2454 cases, 253 (10.3%) patients developed HAP. The incidence of HAP was higher (55.73%) in the age group more than 60 years. Out of 1352 patients on mechanical ventilation, 62.0% of patients (n=157) developed HAP. Conclusions: This study provides an insight into the incidence of HAP with the occurrence being most in the age group more than 60 years. Our study also highlights that mechanical ventilation was an important risk factor for the development of HAP.