The importance of cuff pressure in endotracheal tube management cannot be overstated. Guidelines recommend that a cuff pressure should be in a range of 20 to 30 cm H2O. Low cuff pressure increase risk for micro-aspiration of subglottic secretions. This micro-aspiration is considered the major pathogenic mechanism for ventilator-associated pneumonia, complication with marked morbidity and mortality. Aim: This study was carried out to determine the relation between endotracheal tube cuff pressure and the incidence of ventilator-associated pneumonia. Design: Descriptive research design. Setting: In two critical care units at Assiut Main University Hospital: Trauma ICU and general ICU. Subjects: A convenience sample of 60 critically ill patients. Tools: Three tools were utilized to collect data of study, Tool I: Patient assessment sheet. Tool II: Endotracheal tube cuff pressure measurements. Tool III: Ventilator- associated pneumonia assessment sheet. Method: The researcher used preparatory, implementation and evaluation phases to implement this study. Results: Finding of the present study revealed that there was significant statistical relationship between endotracheal tube cuff pressure and incidence of ventilator associated pneumonia with (P value < 0.05). Conclusion: There is a significant statistical relation between endotracheal tube cuff pressure and incidence of ventilator-associated pneumonia. Recommendations: Endotracheal tube cuff pressure measurements should be standardized as a basic part of care provided to all critically ill patients in intensive care units.