Full Text Article. Also available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6095500/Introduction: Endotracheal suction (ETS) is a common invasive procedure which is done to keep the airways patent by mechanically removing accumulated pulmonary secretions to all in patients with artificial airways. Many life-threatening complications can occur when the procedure is not performed correctly. Although the evidence-based recommendations regarding ETS are available, many of these have not been observed in nurse's clinical practice. We assessed the intensive care nurses' knowledge and practice of ETS to intubated patients in selected hospitals in Dar es Salaam, Tanzania. Methodology: A descriptive cross-sectional study design involving 103 Intensive Care Unit (ICU) nurses in Dar es Salaam city was conducted in 2014. Data were analyzed using SPSS version 20 where descriptive statistics were employed to interpret data. Results: Majority of ICU nurses (69.9%) knew the indication for the procedure, (77.7%) knew the action to be taken in case of abrupt change in the ECG monitor; however, 80.6% demonstrated undesirable overall knowledge on ETS evidence-based recommendations. Nurses with ICU training (57.3%) significantly demonstrated higher knowledge of ETS than nontrained nurses (P<0.005), while all other factors had no influence. Conclusions and recommendations: Majority of ICU nurses do not have desirable knowledge and skills of ETS, and are currently not following current ETS recommendations. This study has shown that training on ICU.