In patients on artificial lung ventilation, the development of ventilator-associated pneumonia, the main causative agents of which are multi-resistant hospital strains of microorganisms, becomes a fairly frequent and formidable complication. Considering the case of initially community-acquired pneumonia in a patient with a rapid transfer to artificial lung ventilation, it should be noted that previous antibacterial therapy with broad-spectrum drugs significantly increased the risk of joining polyresistant nosocomial strains. This complicates the "starting" therapy of nosocomial pneumonia both in the absence of microbiological seeding and, sometimes, in its presence. While maintaining the relevance of the treatment of severe pneumonia caused by a multi-resistant hospital flora resistant to carbapenems, when selecting an alternative treatment, one of the drugs is a representative of the tetracycline series - tigecycline, from the group of glycylcyclines. This publication presents a case of treatment of nosocomial ventilator-associated pneumonia with tigecycline following the results of microbiological examination of sputum, blood, and urine.