The purpose of this self-study activity is to highlight the role of microaspiration in the development of VAP in the ICU to minimize the incidence of VAP in mechanically ventilated patients. There is increasing evidence that microaspiration of contaminated orpharyngeal and gastroesophageal secretions in the airways of intubated and mechanically ventilated patients is implicated in the pathogenesis of ventilator-associated pneumonia (VAP). The incidence and mortality rates of VAP in intensive care units are increasing despite improvements in antimicrobial therapy and use of a variety of preventive measures. Physicians, critical care nurses, advanced practice nurses, infection control specialists, and all healthcare professionals who treat intubated and mechanically ventilated patients need to make well informed and evidence-based decisions to provide quality patient care. This course initially will focus on the impact of intubation on normal body defenses and explore how microaspiration contributes to tracheal colonization and the pathogenesis of VAP. Risk factors for microaspiration and VAP in adult and pediatric mechanically ventilated patients will be addressed. Evidence-based guidelines from the ATS, IDSA and the CDC for the prevention and management of VAP will be summarized and supplemented with recommendations for minimizing microaspiration and VAP. The recent SHEA/IDSA compendium of strategies for prevention of hospital acquired infections will be featured.