To estimate the CT findings of clinically confirmed pulmonary infection in patients with endotracheal intubation and mechanical ventilation.This retrospective study enrolled 48 intubated adult patients with clinically confirmed pulmonary infection and CT examination after intubation in our hospital. Patients were further divided into two groups according to the risk of aspiration. Difference in clinical characters and imaging manifestations were compared between the two groups.The most common CT findings of pulmonary infection in intubated patients were GGO (93.8%) and consolidation (89.6%), followed by lung nodule (56.3%), pleural effusion (56.3%), thickened bronchial wall (50.0%), small airway disease (45.8%), lymphadenopathy (39.6%) and atelectasis (33.3%), but cavity (14.6%) and bronchiectasis (8.3%) were less common. The semi-quantitative scoring results showed significantly higher extent of lung lesions in gravity dependent region for patients in high-risk aspiration group. However, no significant difference was found in low-risk aspiration group. The difference in frequency of cross sectional distribution patterns between gravity dependent and independent region was also statistically significant for patients in high-risk aspiration group, but not in low risk aspiration group.CT has advantage in assessment of lesions type, gravity dependent and cross sectional distribution of pneumonia in intubated patients.