background ventilator associated pneumonia (VAP) is a very challenging infection as it continues to complicate the course of 8% to 28% of patients receiving mechanical ventilation. Abdominal massage is assumed to prevent enteral nutrition related causes of VAP as it decreases gastric residual volume (GRV). Aim of the study was to examine the effect of abdominal massage on decreasing VAP in enterally fed patients, determine the effect of abdominal massage on GRV seen in enterally fed patients. Design quasi- experimental design was used. Setting the study was conducted at ICU in Benha University Hospital. Study subjects: convenient sample of 60 adult male and female patients, divided into two equal groups, study and control, (30 each). Data collection tools: five tools were used: 1) Patient Assessment Tool, 2) Glasgow Coma Scale, 3) Enteral Feeding Assessment Tool, 4) Abdominal Massage Protocol and 5) VAP Assessment Tool. Results: It was found that VAP decreased among study group patients (36.7%) compared with control group patients (63.3%) with a statistically significance difference (X² =4.266, P=0.03). Also, a statistical significance difference was found in GRV between study and control group patients when comparing changes in GRV between the first and last day of the study (X²=6.56, P=0.037). Conclusion this study concluded that abdominal massage could decrease GRV and thus decreasing the risk of VAP among intubated and enterally fed patients. Recommendations Abdominal massage as a noninvasive, inexpensive, and safe method can be used to decrease GRV and aspiration among mechanically ventilated intubated and enterally fed patients.