Pulmonary infection is the most common complication in neurosurgical patients in critical coma, which increases the length and cost of hospitalization and can easily lead to multisystem organ failure. The prevention and treatment of pulmonary infection is a constant part of the treatment of neurosurgical patients in critical care. ① Actively treat the primary disease: timely removal of intracranial hematoma and decompression therapy, application of dehydrating drugs to reduce cerebral edema, and cut off the vicious circle of pulmonary brain damage; ② Strengthen ward management to avoid cross-infection; ③ Timely tracheotomy to remove airway obstruction; ④ Usually, the lateral position is the main focus, with the head of the bed elevated 15°~30°, and the application of vibrating sputum machine to assist in sputum removal; ⑤ Improve the body’s resistance; ⑥ Actively deal with thoracic and abdominal compound injuries; ⑦ Actively deal with the thoracic and abdominal injuries; ⑦ Treat the patient’s body’s resistance. ⑦ Timely and reasonable application of antibiotics, while attention should be paid to the prevention of fungal infection; ⑧ For patients with heavy lung infection, CT or X-ray films showing pulmonary atelectasis or large high-density shadow, fiberoptic bronchoscopy can be used for aspiration, lavage, sputum culture, local application of phlegmolytic drugs and antibiotic treatment. ⑨ Patients with respiratory failure should be treated with ventilator: BP≤90 mmHg, P≥120/min, R≥30/min, SaO2≤85%, PaO2≤60 mmHg, PaCO2≥40 mmHg, and rib fracture≥4 are considered as high-risk indicators, and those with ≥4 of the above high-risk indicators and cannot be relieved after general treatment should be treated with ventilator in time.