Background Nosocomial infections, also known as health care associated infections, have become an important public health issue worldwide. Nosocomial infections pose a critical threat to patients, especially in high-risk departments such as intensive care units. Aim A retrospective review of the incidence of nosocomial infections in the ICU of a tertiary care hospital in Salem from January 2009 to December 2009 was performed. Results Among the 5680 patients who were admitted, the incidence of the nosocomial infection rate was 16%. Urinary tract infections (29.5%) were the most common ones, followed by lower respiratory tract infections occurring in 28.1% of the patients and blood stream infections in 22.8% of the patients. Klebsiella pneumoniae was the most commonly isolated pathogen (23.1%), followed by Pseudomonas aeruginosa (12.7%) and Escherichia coli (10.4%). Conclusion An increased duration of the time spent in the ICU and interventional procedures increase the risk of nosocomial infections.