Abstract: Background Communication with others is essential for the comfort and well-being of any human being (Ashworth 1987). In an intensive care environment, the majority of patients are unable to communicate normally, because of their being sedated, paralysed and intubated or due to mechanical ventilation (Hagland 1995). Hence, in an intensive care unit communication between nurses and patients is likely to be as vital as it is difficult (Ashworth 1981). This study was a partial replication of Ashworth's (1980) study, investigating critical care nurses' verbal and non-verbal communication with mechanically ventilated patients in an intensive care unit (ICU) in Bahrain. Objectives The general aim of this study was to investigate critical care nurses' verbal and non- verbal communication with mechanically ventilated patients in an intensive care unit in one hospital in Bahrain. The particular objectives of the study were to describe the verbal and non-verbal communication and to explore the nurses' perceptions and attitudes towards this communication. The research questions of the study were 'What is the content of nurses' communication with mechanically ventilated patients and how much time is spent in this communication'? The second question was 'What are the attitudes and perceptions of nurses on verbal and non-verbal communication with mechanically ventilated patients'? Method This research study was descriptive-exploratory in nature using both quantitative and qualitative approaches. Observation and interviews were the two methods that were used to conduct this research. A non-probability convenience sampling method was used and ten nurses were observed and interviewed. The data from observation was analysed using the Statistical Package for the Social Scientist version 10.0 (SPSS 10.0) for windows and Microsoft excel version 2002. The data from the interviews was analysed by using a method of thematic content analysis, suggested by Burnard (1991). Findings Analysis indicated that the minimum time spent in verbal communication was 35 seconds and the maximum time 4 minutes and 33 seconds in a 2-hour observation. A great part of this communication involved informing the patients about the immediate procedure being performed, providing reassurance and request or command. Touch was used by only seven nurses and the maximum times touch used was 4 times during a 2 hour observation period. The barriers to communication identified by nurses were the condition of the patient, language barrier, nurses' emotional status and their workload and finally emotional status of the patients. All the nurses felt frustrated with difficult communication and reported that communication with patients, particularly touch, is influenced by their religious and cultural beliefs. Most nurses felt that communication is important in the intensive care unit. Conclusion This study has evaluated an area of practice that was not previously investigated in Bahrain. Findings of this study may increase awareness about communication in the intensive care unit and improve practice in Bahrain.