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Pseudomonas aeruginosa (P. aeruginosa) is a Gram-negative, aerobic, rod-shaped and polar-flagella bacterium with unipolar motility, and an opportunistic pathogen responsible for ventilator-acquired pneumonia (VAP). VAP due to P. aeruginosa is usually multidrug-resistant and associated with severe infection and increased mortality. The large genome and the high level of gene regulation may explain part of the significant virulence and of the prominent adaptability to different environments of this pathogen. In this review, we discussed the potential relationship between some of the virulent factors of P. aeruginosa and outcome of patient with VAP.