The clinical progress and weaning of invasive mechanical ventilation are difficult in patients who have muscle and lung pathologies when they were underwent invasive mechanical ventilation. We present a case who had recurrent invasive mechanical ventilation with undefined muscle disease. The mental motor retired male patient was admitted the intensive care unit with high fever and respiratory failure. The patient was diagnosed as pneumonia and also had neuromuscular disease. The patient was intubated because of worsening respiratory failure. He required recurrent invasive mechanical ventilation period for two months and afterwards discharged with successful treatment period. The rate of mortality, morbidity, and aspiration pneumonia is signifcantly high in patients with mental motor retardation, neuromuscular pathology, muscular atrophy, malnutrition, and respiratory distress. The treatment period is long and very challenging in these patients due to recurrent invasive mechanical ventilation those required close follow up and monitoring. © 2011 OMU All rights reserved.