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Chernet Manaye Belay,1 Taye Abuhay Zewale,2 Baye Tsegaye Amlak,3 Tiruayehu Getinet Abebe,4 Getachew Hailu2 1Department of Nursing, Tibebe Ghion Specialized Hospital, Bahir Dar University, Bahir Dar, Ethiopia; 2Department of Epidemiology and Biostatistics, Bahir Dar University, Bahir Dar, Ethiopia; 3Department of Nursing, Debre Markos University, Debre Markos, Ethiopia; 4Department of Public Health, Debre Tabor University, Debre Tabor, EthiopiaCorrespondence: Baye Tsegaye Amlak, Department of Nursing, Debre Markos University, Debre Markos, Ethiopia, Tel +251 948702095, Email 93baye2007@gmail.com Chernet Manaye Belay, Department of Nursing, Tibebe Ghionspecialized Hospital, Bahir Dar University, Bahir Dar, Ethiopia, Tel +251 923557454, Email cherumanaye@gmail.comIntroduction: Ventilator-associated pneumonia refers to pneumonia that happens at least 48 hours after endotracheal intubation. It is associated with high economic costs, longer attributable lengths of stay in the hospital, and high mortality. Therefore, this study aims to determine the incidence and predictors of ventilator-associated pneumonia among adult intensive care unit admitted patients at Bahir Dar Specialized Hospitals.Methods: A retrospective follow-up study was conducted among 312 adult intensive care unit admitted patients. A data extraction checklist was used to collect the data. The collected data were coded, cleaned, and entered into EpiData version 3.1 and exported to SPSS version 22 and STATA version 14 for analysis. Descriptive analysis was done by using tables, text and percentages. Bivariable and multivariable log binomial analyses were conducted to identify predictors of ventilator-associated pneumonia. Variables having p-value < 0.05 were considered statistically significant.Results: The study found that 27.9% (95% CI: 23%– 33%) of patients developed ventilator-associated pneumonia and the incidence rate of VAP was 45.7 per 1000 ventilator days. Patient’s stay more than or equal to 14 days (ARR: 13, 95% CI: 9.3– 31) and 7– 13 days on MV (ARR: 7.2, 95% CI: 6.2– 11), blood transfusion (ARR: 2.8, 95% CI: 1.1– 6.9), low GCS (ARR: 2.5, 95% CI: 1.3– 5.1), use of corticosteroid (ARR: 2.1, 95% CI: 1.1– 4.1), and supine head position (ARR: 8.1, 95% CI: 1.7– 40) were identified as independent predictors of ventilator associated pneumonia.Conclusion: Nearly one-fourth of the participants developed ventilator-associated pneumonia. Duration of ventilation, blood transfusion, corticosteroid use, supine head position, and low Glasgow coma scale were significant predictors of ventilator-associated pneumonia.Keywords: ventilator-associated pneumonia, predictors, incidence, intensive-care unit, adult patients, Ethiopia