OBJECTIVE: To study the efficacy of endotracheal lavage in neonatal ventilator-associated pneumonia (VAP). METHODS: Fifty-eight neonates with VAP between January 2002 and December 2008 were randomly assigned to two groups: lavage and control (n=29 each). After withdrawal from ventilator, both groups received sensitive antibiotics therapy according to sputum culture results as well as supportive treatment. The lavage group was additionally treated with endotracheal lavage (2-3 times daily). The therapeutic effects were compared between the two groups. RESULTS: There were no significant differences in the average time of mechanical ventilation between the lavage and the control groups. The effective rate in the lavage group (93%) was significantly higher than that in the control group (69%; P<0.05). Three percent of patients in the lavage group required twice or more mechanical ventilation compared with 24% in the control group (P<0.05). Blood gas analysis results were obviously improved in the lavage group 2 hrs after treatment (P<0.01). CONCLUSIONS: Endotracheal lavage can decrease the number in mechanical ventilation and improve therapeutic effects in neonates with VAP.［Chin J Contemp Pediatr, 2010, 12 (3):195-197］