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Ventilator-associated pneumonia (VAP) is a severe infection among patients in the neurosurgery intensive care unit (NICU). We retrospectively evaluated risk factors for early-onset ventilator-associated pneumonia (EOVAP) from January 2019 to December 2019 at a NICU. A total of 89 NICU patients who were intubated within 48h of onset and whose mechanical ventilation time was at least 7days were enrolled. We evaluated EOVAP that occurred within the first 7days after the onset of mechanical ventilation. The enrolled patients had no history of chronic lung disea