Background: Health care burden of Ventilator Associated Pneumonia (VAP) can be represented by the prolonged hospital stay, long-term disability, and the massive additional financial costs for the health care system. Aim: To assess the health care burdens of ventilator associated pneumonia in Pediatric Intensive Care Units. Design: A descriptive design was utilized. Setting: The study was conducted in Pediatric Intensive Care Units at Children's Hospital that is affiliated to Ain Shams University. Subjects: A purposive sample of children suffering from VAP (40 children), a convenient sample of pediatric nurses working in the PICU (40 nurses), Tools: Structured questionnaire sheet to assess nurses' demographic data, and their knowledge regarding VAP. Assessment of children characteristics, treatment, and diagnostic studied; Observational checklist for nurses' performance; PICUs environment physical assessment; and parameters of VAP health care burdens. Results: The majority of the studied nurses had poor level of knowledge regarding VAP, while about two thirds of them were incompetent regarding care of children with VAP. Most of the studied children' age was less than one year, while the minority of them were more than 11 years old. The Incidence of VAP was 563 per 1000 children high risk for VAP. Total hospitalization cost was 496696.8 LE for the total number of the studied children with VAP. Conclusion: Based on the study findings, it could be concluded that, ventilator associated pneumonia had a great burden among the mechanically ventilated children in the pediatric intensive care units, which is strongly related to the poor levels of nurses' knowledge and practices regarding VAP. Recommendation: Burden parameters of ventilator-associated pneumonia should be adopted as blueprints for PICU staff adherence to the guidelines.