BSTRACT This study aims to compare the effectiveness of endotracheal intubation with mechanical ventilation and noninvasive ventilation as the most in common methods used in management of ICU chest trauma patients. Sixty-eight patients with chest trauma aged 20–70 years were participated in this study for 2 years. The patients attended to cardiothoracic surgery department, Zagazig University Hospital. The Patients enrolled in this study were divided into 2 groups: the first one received endotracheal intubation with mechanical ventilation (MV group) (Group 1, n = 34) and the other received noninvasive ventilation (NV group) (Group 2, n = 34). All enrolled patients were monitored with clinical criteria including RR, HR, MAP and SpO2. The software SPSS was used for the statistical analysis. P value < 0.05 was considered as statistically significant. The present study resulted that the mean HH, HR, pO2, pCO2 and P/F ratio were improved in the MV group as well as in the NV group but this improvement was not significant. The use of noninvasive ventilation reduces mortality, damages, and complications as well as the length of stay in intensive care (ICU), which leads to low cost