Background: One of the major causes of serious infections in both community and institutional settings is Staphylococcus aureus, with methicillin-resistant strains causing numerous invasive infections, especially those involving the bloodstream. Some practitioners have extrapolated these dosing recommendations with associated trough concentration goals to all vancomycin use. However, evidence of superior efficacy is lacking, and results of several single-centers, mostly retrospective trials have suggested that this more aggressive dosing may be related to an increased incidence of vancomycin-related nephrotoxicity and ototoxicity. Therefore, we retrospectively analyzed the rate of renal toxicity in patients treated with vancomycin for MRSA health care–associated pneumonia confirmed by bronchoalveolar lavage cultures. Materials & Methods: The present study was carried out in the department of pharmacology and renal medicine and included all the patients with MRSA HCAP, microbiologically confirmed by BAL semiquantitative cultures, who were treated with vancomycin were eligible for this investigation. Patients with polymicrobial infection demonstrated by BAL cultures, those treated with vancomycin for <72 hours, and those with acute renal failure or requiring dialysis were excluded from evaluation. For all study patients, the following information was recorded by one of the investigators; age, sex, weight, serial serum creatinine (SCr) measurements, age- and sex-adjusted creatinine clearance (CrCl) and other parameters. Patients must have received the potentially renal toxic medication(s) while on vancomycin and before the maximum documented SCr (SCrmax) during treatment. Vasopressor use was considered when it was initiated or maintained within 48 hours before SCrmax. All the results were analyzed by SPSS software. Chi-square test was used for the assessment of level of significance. Results: Mean age of the patients in group without and with renal toxicity was 58.2 and 61.2 years respectively. The mean male’s percentage in the patients of the group without renal toxicity and with renal toxicity was 58.2 and 69.2 respectively. 71.5 % and 81.7% were the mean percentage of whites in the group without and with renal toxicity. Mean APACHE II score in patients without and with renal toxicity was 18.6 and 23.1 respectively. Non-significant results were obtained while comparing the two study groups for the mean serum creatinine concentration and mean creatinine clearance. Significant correlation was obtained while comparing the vancomycin serum trough serum conc. (µg/mL) and percentage of renal toxicity. Conclusion: Among patients treated for MRSA HCAP, aggressive vancomycin dosing and prolonged administration of vancomycin may be associated with renal toxicity.