Background: Mechanical ventilation via an endotracheal tube (ETT) or tracheostomy can lead to a condition known as ventilator associated pneumonia (VAP). Up to 20% of all nosocomial infections in pediatric care facilities following blood stream infections are most commonly brought on by Ventilator Associated Pneumonia (VAP). Pediatric intensive care units (PICUs) and neonatal intensive care units (NICUs) had very different rates of VAP infections per 1000 ventilator days. Patients who have VAP are more likely to have a longer stay in the hospital and a higher rate of morbidity and mortality. If implemented, "Zero VAP" was found to be an all-encompassing strategy for prevention of higher rates of VAP in Spain. This strategy could be widely used for more prevention of VAP globally. Objective: To evaluate the role of the Spanish "Zero- VAP" bundle in reduction of VAP in PICU. Conclusion: Zero-VAP compromises of many levels among health working personnel and system, it gives a clear description of steps, approach, preventive actions to minimize incidence of VAP among ICUs that could be used globally.