Aim of the study: To evaluate the method and clinical efficacy of aspiration precaution bundle (APB) on critically ill patients with risk of aspiration and aspiration pneumonia in comparison with preventive strategies. Methods: A retrospective study was conducted to analyze the clinical data from sixty-two critically ill patients from both sexes had risk of aspiration or aspiration pneumonia. The patients were divided into two groups: control group included 30 patients underwent preventive strategies against aspiration and bundle group included 32 patients and underwent APB. Both groups were compared regarding, identification of risk factors for aspiration and aspiration pneumonia, the incidence of aspiration pneumonia ( its numbers and rate), the incidence of complications and the mortality rate related to aspiration. Both groups were compared in regards of length of stay (LOS), competency of bundle and preventive strategies or protocols. Results: Both groups showed same LOS and can identify the risk factors of aspiration and aspiration pneumonia. Bundle group showed reduction in the rate of aspiration pneumonia and mortality rate without any statistically significant difference between groups P > 0.05. No significant differences between both groups as regards complications and competencies of bundle and preventive strategies P > 0.05. Conclusion: APB had the same effect of preventive strategies against the risk of aspiration pneumonia and its related complications, mortality and LOS. So, it can be used as alternative for preventive methods. Keywords: Aspiration, aspiration pneumonia, aspiration precaution bundle