OBJECTIVE To explore the characteristics of the pathogens in ventilator-associated pneumonia (VAP) following severe craniocerebral trauma. METHODS The 220 cases with severe craniocerebral trauma were analyzed retrospectively. RESULTS The incident rate of VAP was 24% in these patients. A total of 169 pathogens were isolated,including 146 ( 86%) strains of bacteria and 23 (14%) fungal isolates. The main Gram-negative bacteria (114 strains) were Pseudomonas aeruginosa,Escherichia coli,Klebsiella pneumoniae,etc. The Gram-positives (32 strains) were Staphylococcus aureus and twenty-four (75%) of them were meticillin-resistant. CONCLUSIONS The incident rate of VAP is high following severe craniocerebral trauma. Most of the isolated pathogens are drug resistant. These cases have mixed infection occurred commonly. To prevent and treat VAP,we should pay attention to disinfection and aseptic manipulation,and make the rational use of antimicrobial agents.