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Please confirm that an ethics committee approval has been applied for or granted: Yes: I’m uploading the Ethics Committee Approval as a PDF file with this abstract submissionBackground and Aims Ventilator associated pneumonia (VAP) is a type of nosocomial infection that affects the lung parenchyma of patients who are on invasive mechanical ventilation (MV) via an ETT or tracheostomy tube for period longer than 48 hours. VAP is most common nosocomial infection in ICU patients with an incidence rate of 13–51 per 1000 ventilator days. Incidence of VAP is about 5–40%, with much variations depending upon the geological region, ICU type, and the criteria used to label as VAP.Methods This retrospective clinical audit was done in surgical ICU (SICU) of Doctors Hospital and Medical Centre, Lahore, Pakistan over one year period from 1st January 2023 to 31st December 2023. Data was collected using non-probability consecutive sampling. Data was recorded and analysed in IBM SPSS Statistics 29.0. Descriptive statistics like frequencies and descriptives are used. SPSS output file is provided with the text. One sample t-test was applied. A p-value was set at <0.05 and confidence interval was set at 95%.Results Out of 538 patient admitted in ICU, 213 patients were on mechanical ventilation. Out of these 213 patients, 51 tracheal cultures were positive.A total of 22 cultures were positive on admission, so they were excluded. A total of 29 tracheal cultures became positive after 48 hours of mechanical ventilation during this study period, and these were sent on suspicion of ventilator associated pneumonia. Total number of mechanical ventilation days for all of the ventilated patients in ICU were 871 and VAP rate came out to be 33.3 per 1000 ventilator days.Conclusions Ventilator associated pneumonia remains prevalent in ICU patients and a public health issue with various predictors including prolong mechanical ventilation, low GCS and patients having traumatic brain injuries.