Background: Ventilator associated pneumonia is the most common infection in ICU in patients on mechanical ventilation with incidence between 7 to 47%. Aims of the study: The aim of study was to determine incidence of VAP in an ICU of tertiary care hospital and to find out etiology and antibiotic sensitivity pattern of isolates. Material and Methods: The study was conducted over a period of two years. Endotracheal aspirate was obtained from patients put on mechanical ventilation for >48h and presenting with pneumonia. Semiquantitative cultures were performed and VAP was diagnosed if the cfu was >105/ml. Antibiotic sensitivity was also performed by Kirby Bauer method. Results: The overall incidence of VAP was found to be 32.63%. Acinetobacter sp was the commonest organism. All other organisms were multidrug resistant. Conclusions: VAP continues to be major threat to patients. Since it is caused by multidrug resistant bacteria and there is no difference in etiology of early and late onset VAP, it seems that the bacteria come from hospital environment probably ventilator itself