Ventilator-associated pneumonia (VAP) is a serious complication of mechanical ventilation that increases the risk of patient morbidity and mortality. It has been reported that patients on continuous ventilation are as much as 21 times more likely to develop pneumonia than non-intubated patients. The endotracheal tube interferes with patient defenses as well as with reflexes that would normally prevent direct pathogen access to the lungs. This educational program will describe why ventilated patients are susceptible to pneumonia and review strategies that will reduce the occurrence of VAP. Positive and negative aspects of VAP diagnostic procedures will also be discussed.