Introduction: The aim of this study was to contribute to improving the management of ventilator-associated pneumonia (VAP) in the Intensive Care Unit of Treichville University Hospital. Patients and Methods: This was a retrospective descriptive and analytical study conducted in the Department of Anaesthesia and Intensive Care of Treichville University Hospital over a 54-month period, from 1 January 2020 to 30 June 2024. Results: Fifty-two patients out of 1,250 admissions developed microbiologically confirmed ventilator-associated pneumonia, corresponding to an incidence of 4.16%. The mean age was 41.48 years (range : 2–80 years), with a male-to-female ratio of 1.5. The associated comorbidities were hypertension in 20 patients (38.48%), diabetes mellitus in 9 (17.31%), asthma in 3 (5.76%), HIV infection in 1 (1.92%), and pulmonary tuberculosis in 1 (1.92%). Klebsiella pneumoniae was the most frequently isolated pathogen (36.54%), followed by Pseudomonas aeruginosa (21.15%). The mean hospital stay was 27.65 days (range: 11–62 days). The mortality rate among patients with VAP was 69%. Factors significantly associated with mortality were age >40 years (P = 0.013), duration of mechanical ventilation >15 days (P = 0.006), late-onset VAP (P = 0.045), and Gram-negative bacterial infections (P = 0.032). Conclusion: Ventilator-associated pneumonia remains a frequent and serious nosocomial infection, associated with high morbidity and mortality among mechanically ventilated patients.