Background: Hospital acquired infections continue to be an important cause of morbidity and mortality among hospitalized patients. Though Hospital Acquired Pneumonia (HAP) is widely analyzed by many researchers, not much is known about the incidence and bacteriological profile i.e., only few studies are being published by them. This study is conducted to evaluate bacteriological profile of HAP in Intensive Medical Care Unit (IMCU) patients. It may increase the awareness of clinicians about the need to reduce the morbidity and mortality by coming to know about the various pathogens causing HAP and its sensitivity and/or resistance to various antibiotics. The aim of this study was to analyze the incidence, epidemiology and antimicrobial susceptibility pattern of isolates from HAP patients in IMCU. Materials and Methods: This prospective study was conducted over a period of one year among 2454 patients admitted in IMCU of Coimbatore Medical College & Hospital, Tamil Nadu. The Specimens Sputum, Bronchoscopic Alveolar Lavage (BAL), Endotracheal aspirate (ETA) and Blood were collected and processed using standard laboratory techniques. Results: Out of 2454 cases, 253(10.3%) patients developed HAP. Totally 145 sputum samples, 70 BAL and 38 ETA were collected and processed.The commonest organism isolated was Klebsiella pneumoniae (48.2%) followed by Pseudomonas aeruginosa (15.3%), E.coli (8.4%), Acinetobactor species (7.7%), Proteus species (6.9%), MRSA (6.2%), MSSA (5.1%), Serratia species (0.7%), Enterobactor species (0.7%), Streptococcus pneumoniae(0.4%) and Candida albicans (0.4%). All Gram negative bacterial isolates had 100% sensitivity to Imipenem. 82% (n=108) of Klebsiella pneumoniae and 52% (n=12) of E.coli were found to be ESBL producers. Staphylococcus aureus had a maximum sensitivity to Vancomycin followed by third generation cephalosporins. 54.84% (n=17) of Staph.aureus were Methicillin Resistant strains. Conclusion: The antibiotic susceptibility pattern of the isolates will help the clinicians to choose the appropriate antimicrobial agents for prophylactic as well as treatment purposes.