Ventilator-associated pneumonia (VAP) is the second most common hospital-acquired infection in pediatric intensive care units (PICUs). It is linked to increased morbidity, mortality, and length of stay in the hospital and intensive care unit, adding tremendously to health care costs. Therefore prevention is the most appropriate intervention. The aim of this study is to (1) assess nursing interventions, (2) identify the risk factors for VAP in PICU at Assiut University Children Hospital. Subjects and Method: A prospective cohort study design was utilized during one year. The study included 65 pediatric patients were divided into two groups: group (I) pediatric patients developed VAP (20 cases) and group (II) pediatric patients who did not develop VAP (45 cases). Two tools were used, (1) questionnaire sheet and (2) observation checklist. Results: It was found that the risk factors associated with VAP were duration of mechanical ventilation and inadequate application of infection control policies and care for it. Conclusion and Recommendations: There were risk factors associated with VAP were duration of mechanical ventilation and inadequate application of infection control measures and hygienic care, which increase morbidity, mortality and hence the cost of VAP in the PICU.