Severe community-acquired pneumonia (CAP) is one of the most common causes of admission to the intensive care unit, and ventilator-associated pneumonia (VAP) is one of the most serious complications of care in the intensive care unit. Important data regarding the time to reach clinical stability in patients with severe CAP potentially has an impact on clinical practice in important areas. Recent literature also has focused on the etiology, therapy, and possible prevention of CAP after aspiration. In VAP, the debate continues over the optimal diagnostic technique, diagnostic thresholds, and the impact of these on patient outcome. Further work on the etiology and prevention of VAP are reviewed. The importance of the initial choice of treatment for VAP and the difficulty in choosing appropriate initial empiric therapy are also highlighted.