Endotracheal cuff pressure monitoring is an essential part of airway management, especially in critically ill patients undergoing mechanical ventilation. The aim was to evaluate the effect of suctioning on endotracheal cuff pressure monitoring during fixed volume versus minimal leak techniques among mechanically ventilated patients. Design: A quasi-experimental research design was used to conduct the current study using a pre post technique approach. Setting: This study was conducted at both Anesthesia and Surgical Intensive Care Units affiliated to Tanta University Hospitals, Subjects: A convenience sample of 60 adults who were newly admitted to Intensive Care Units within 48 hours and undergoing oral or nasal endotracheal tube. Tools: Two tools were utilized to collect data; (tool I) patients' bio-sociodemographic characteristics and (tool II) endotracheal cuff pressure assessment. The results clarified that there were highly statistically significant differences regarding intra cuff pressure pre and post suctioning in both fixed volume and minimal leak techniques groups with a p-value