Background: Neonatal ventilator-associated pneumonia (VAP) is recognized as a nosocomial lower airway infection in neonates with invasive mechanical ventilation who present beyond 48 hours. Besides the role of Vitamin D in calcium and phosphorus homeostasis, and bone metabolism, multiple reports suggested the vital role of vitamin D in immune system function and regulation since 1,25 dihydroxy vitamin D can promote the innate immature response to the pathogen. The objective was to study role of vitamin D level as early predictors of VAP in the neonatal intensive care unit