Abstract Background The treatment of ventilator-associated pneumonia (VAP) secondary to methicillin-resistant Staphylococcus aureus (MRSA) remains controversial. Methods We performed a review of all blunt trauma patients diagnosed with MRSA VAP from June 2005 to June 2011. VAP for the first 3 years was diagnosed by sputum aspiration and treated with vancomycin. For the last 3 years of the study period, VAP was diagnosed with bronchoalveolar lavage and treated with linezolid. Results MRSA VAP patients treated with vancomycin had an average hospital length of stay (LOS) of 49 days (range 9–99 days), an average intensive care unit (ICU) LOS of 43 days (range 6–98 days), and average ventilator days of 34.4 (range 3–76 days). Seventeen MRSA VAP patients treated with linezolid had an average hospital LOS of 27 days (range 11–61), an average ICU LOS of 22 days (range 10–42) days, and average ventilator days of 16.6 (range 2–42). Conclusions Trauma patients who develop MRSA VAP appear to have fewer ventilator days and shorter ICU and hospital LOS when treated with linezolid.