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Objectives: Despite in techniques advancement to patient care for respiratory tracts are instrumented may complicate the IAP course up to 50% in patients with mechanical ventilation. It requires rapid diagnoses and treatment that is appropriate as per patient condition. Many studies revealed negative impact with delayed administration and antibiotic treatment in IAP patients may increase the hospital mortality and morbidity. The primary objective of the study was to estimate the incidence of IAP in the patient admitted in ICU of tertiary care hospitals in Rawalpindi Pakistan. Study Design: Observational cross sectional study. Setting: ICU units of various tertiary care hospitals in Rawalpindi, Pakistan. Period: One year from Dec 2016-Dec 2017. Materials and Methods: A total 450 subjects were enlisted for the study; these patients were selected randomly. The exclusion criteria include all patients with Acute Respiratory Distress Syndrome (ARDS) or those on long-term antibiotic or steroid therapy and all the pregnant women whereas all the patients of both sexes, kept on ventilator for more than 48 h and above the age of 18 years were included in this study. Results: We enrolled a total of 450 patients for this study. The average age of all the participants was 61.51 + 12.8 with range 36-91. 230(51.1%) of the patients were male whereas 220(48.9%) were females. The Trauma-Pulm contusion was absent in all patients. In ICU 150 (33.3%) were diagnosed with COPD, 150(33.3%) with Asthma, 220(48.9%) with ARDS, 10 (2.2%) with head trauma and 310 (68.8%) with diabetes.200 (44.4%) smokers, 40(8.8%) were having lung cancer, 310(68.8%) were hypertensive and 20 (4.4%) were with Pneumothorax - requiring Chest Tube. Conclusion: We may conclude from our study that ICU associated Pneumonia is a serious issue, that developed with longer hospital stay, duration of mechanical ventilation and re-intubation. By reducing the mechanical ventilation duration, pneumonia can be controlled. [ABSTRACT FROM AUTHOR]