Introduction: Ventilator associated pneumoniae is one of the most common hospital-acquired infections and is a major device-associated complication encountered in critical patients receiving intensive care. Knowledge of VAP rates the common etiological agents in the critical areas of health care institutions and can help to plan empirical antimicrobial treatment. Aim: To study the etiology and antimicrobial resistance of bacteria responsible for VAP. Objectives: (1) To estimate VAP rate / 1000 ventilator days. (2) To study the bacteriology of Ventilator Associated Pneumonia (VAP). (3) To identify bacterial isolates up to species level. (4) To study anti-microbial susceptibility in the bacterial isolates. Methods: The study was conducted in the Department of Microbiology of an urban tertiary care teaching hospital in Western India. The patients were admitted to the MICU during the study period who received mechanical ventilation (MV) for >48 hours and developed pneumonia, diagnosed on clinical and radiological findings were the study population to calculate the VAP rate and find out the etiological agents. Antimicrobial Susceptibilities were performed on the bacterial isolates recovered from VAP cases. Results: A total of 125 patients developed clinical VAP proven by radiological and clinical findings out of 271 patients on mechanical ventilation studied. The VAP rate was calculated as 35.7 in 1000 ventilator days. The incidence rate of VAP was 46.12%. Late on-set VAP accounted for 66% of cases. All the clinically suspected 125 VAP cases were culture positive with 77% positive predictive value for culture-positive samples and 100% negative predictive value for culture-negative samples. The majority of the isolates of VAP comprised multi drug resistant gram-negative organisms like K. pneumoniae, A. baumannii, and P. aeruginosa. Conclusion: VAP is a major cause of morbidity and mortality in critically ill patients admitted to the critical care unit. Multidrug-resistant bacteria are frequently involved in the causation of VAP. Hence, microbiological information could be used for planning antibiotic therapy and should not be limited only to making a diagnosis.