Abstract Background: Ventilator Associated Pneumonia (VAP) is a common concern in Intensive Care Unit (ICU), where many risk factors have been reported to be associated with it. VAP can increase patient's length of stay in ICU and possibly causes high mortality rate. Application of several interventions have been found to reduce incidence of VAP, including head of bed elevation, deep vein thrombosis prophylaxis, peptic ulcer disease prophylaxis, daily sedation vacation, daily assessment for readiness for extubation, daily spontaneous breathing trial, and oral care with chlorohexadine. These interventions are called ventilator care bundle. Echinacea is a herb that has been utilized to strengthen the body's innate resistance. It contains multiple active compounds which gives it its medicinal qualities, it has been shown to reduce the severity of respiratory infections. Aim of Study: The aim of this study was to evaluate the effect of adding Echinacea to ventilator care bundle in intubated and ventilated ICU patient on length of stay in ICU and mortality. Material and Methods: This clinical trial included 80 patients who were intubated and mechanically ventilated within 48 hours of admission to ICU in Surgical Intensive Care Unit (SICU) in Kasr Aini Hospital during the period between December 2013 and December 2014. All patients were adults more than 18 years, who have no witnessed aspiration or pneumonia on admission. Intervention: Patients were divided into two equal groups of 40 patients each, one group received Echinacea in the form of Immulant capsules and the other didn't receive it. Both groups have ventilator care bundle applied. All patients were followed-up clinically, radiologically and by laboratory. Length of ICU stay, mortality and VAP associated mortality were calculated in both groups. Results: Both length of stay in ICU and mortality had no statistical significance in both groups, but VAP associated mortality had decreased significantly in the group that received Echinacea. Conclusion: Echinacea may be found to decrease VAP associated mortality.