Background: Nosocomial pneumonia is a common infection with a high rate of morbidity and mortality. It significantly prolongs the hospital stay and associated higher economic burden. We in the current study tried to analyze the clinical and radiological pattern of hospitalacquired pneumonia including the causative organisms and risk factors. Methods: This cross-sectional study was conducted in the intensive care units of Government Medical College, Mahabubnagar, Telangana. All adult patients who develop nosocomial pneumonia in critical care units as per the definition in inclusion criteria are investigated clinically, radiologically, and bacteriologically to determine the presence of pneumonia, isolate causative microorganisms, and presence of comorbid conditions like DM, COPD, CRF, etc. Results: Out of n=40 cases hospital-acquired pneumonia was diagnosed in n=22 and ventilator-associated pneumonia was diagnosed in n=18 cases. important radiological findings in HAP of early-onset showed the presence of infiltrates similarly in the late-onset HAP infiltrates were found in maximum cases followed by consolidation and cavity formation. K. pneumoniae was the commonest organism isolated from 40.90% of all cases of HAP. In earlyonset HAP the isolation of the organism was in 18.18% of cases and S pneumoniae was the second commonest organism isolated from 13.63% cases of HAP who were not mechanically ventilated. Conclusion: All 100% cases with HAP of early-onset recovered were as of late-onset HAP 78.5% recovered. In early-onset VAP cases 80% of cases recovered whereas in late-onset VAP only 69.2% cases recovered. Based on the microorganism involved the prognosis was good in cases infected with K. pneumoniae and S. pneumoniae and the worst prognosis was found in cases infected with Pseudomonas Aeruginosa.