Introduction: The impact of gender on outcomes among critically ill patients with infections, including pneumonia, is controversial. Hypothesis: We hypothesized that there is no impact of gender on clinical outcomes and resource utilization in intensive care unit (ICU) patients with hospital-acquired pneumonia (HAP). Methods: Data from ICU patients diagnosed with HAP, including ventilator-associated (VAP) and healthcare-associated pneumonia (HCAP), were collected from an observational performance improvement project at four academic institutions (IMPACT-HAP study). This analysis was performed retrospectively. Outcomes included 28-day mortality, clinical failure at day 14, hospital and ICU length of stay (LOS) and duration of mechanical ventilation after diagnosis of pneumonia. Baseline patient characteristics between men and women were compared. Chi-squared or Fisher’s Exact tests were used to compare categorical variables and the t-test or Mann-Whitney U-test was used to compare continues variables. Results: Of the 416 adult ICU pneumonia patients, 271 were men and 145 were women. Women, as compare to men, were older (62.4 ± 16.9 vs. 55.7 ± 16.5 years of age, (mean,SD) (P<0.001), and more critically ill with baseline APACHE II scores of 21 [16,28] vs. 19 [15,25] (mean [IQR]) (P=0.004). Day-28 mortality was 34/145 (30%) for women and 49/271 (24%) for men (P=0.25). Using multivariate logistic regression, factors associated with increase day-28 mortality included severity of illness (APACHE score, severe sepsis at baseline), age, VAP diagnosis, history of vascular disease, and LOS prior to development of pneumonia. No differences were noted in the distribution of bacterial pathogens or in clinical failure rates in women 48/145 (36%) vs. 78/271 (31%) in men (P=0.34). Hospital LOS (16 [9,26] vs. 15 [9,28]), ICU LOS (11 [5,20] vs. 12 [6,22]) and duration of ventilator support (8 [3,15] vs. 8 [2,15]) in days (median [IQR]) were similar for women compared to men respectively. Conclusions: In our ICU pneumonia patients, female gender was not associated with worse outcomes or increase in resource utilization. Additional studies are needed to further clarify the influence of gender on ICU patients with hospital-acquired pneumonia.