Ventilator-associated pneumonia (VAP) is a significant healthcare challenge in intensive care units, typically occurring in patients who have undergone mechanical ventilation for at least 48 hours. It is associated with high morbidity, mortality, and healthcare costs. VAP develops due to respiratory tract colonization by pathogens, facilitated by invasive devices like endotracheal tubes. Common bacteria include Pseudomonas aeruginosa, Escherichia coli, and Staphylococcus aureus. Risk factors range from prolonged ventilation to prior antibiotic use and underlying health issues. Diagnosing VAP is difficult due to overlapping symptoms with other lung conditions and the absence of standardized criteria, often leading to antibiotic overuse. Preventive strategies—such as ventilator care bundles, elevating the head of the bed, maintaining oral hygiene, and staff training—are critical to reducing its incidence. While progress has been made, ongoing research and consistent application of evidence-based practices are essential to improve outcomes and lower the burden of VAP in ICU settings.