The intensive care unit (ICU) is a high-incidence area for hospital-acquired infections (HAI). The most common of infections are respiratory infections, including hospital-acquired pneumonia ( HAP) and ventilator-associated pneumonia ( VAP). Hospital-acquired infections increase the burden on patients and worsen the clinical prognosis. This article systematically analyzes the classification, epidemiological characteristics, pathogenesis and pathogen spectrum of hospital-acquired respiratory infections. Furthermore, it elaborates on eight key prevention and control measures. The measures include a care bundled management for screening the drug-resistant bacteria, enhancing the hand hygiene compliance, cleaning and disinfecting the environmental and equipment, implementing the isolation precautions, employing the microbial surveillance and environmental management and optimizing the ICU layout and infrastructure as well as improving the management of antibiotics and multidrug-resistant organism ( MDRO). The study aims to provide a systematic and evidence-based solution for ICU respiratory infection prevention. It ultimately improves the patient healthcare quality.