Background: MV is an important part of NICU care today. MV, nevertheless, is linked to higher risks of VAP. The 2nd most frequent hospital acquired infection is VAP, which develops in mechanically ventilated cases after 2 days of MV. Aim: The aim of this study was to determine the incidence of VAP and to assess risk factors of VAP in neonatal intensive care unit in Al-Ahrar teaching hospital. Methods: This study was a prospective observational study which conducted at the neonatal intensive care unit in Al-Ahrar teaching hospital on 84 neonates on MV. All patients were subjected to full history taking. Full Clinical Examination and Laboratory Investigations were done and included complete blood count (CBC), C-reactive protein (CRP), liver function tests, kidney function tests, serum albumin level and blood culture. Chest radiograph was done on admission and repeated as required. Results: the percentage of the VAP was (54.8 %). There was a statistically significant decrease in gestational age, weight, and serum albumin among VAP than non-VAP cases. Conclusion: The high prevalence of VAP in the intubated neonates poses a serious risk. Diagnosis, risk factor identification, precautions, and empirical treatments are all important strategies for VAP. VAP was found in a high percentage of mechanically ventilated newborns.