Objective To investigate the clinical value of fiberbronchoscope-assisted treatment of severe ventilator-associated pneumonia, and to provide reference for clinic. Methods 100 patients with severe ventilators-associated pneumonia admitted to Linyi CentralHospital from January 2021 to June 2022 were selected as research objects, and were divided into control group and study group according to random number table method, with 50 cases in each group. The control group received conventional treatment, and the study group received combined bronchoscopic alveolar lavage on the basis of the control group. The clinical indexes, blood gas indexes, lung ventilation indexes, inflammation indexes and complications were compared between the two groups. Results The mechanical ventilation time, pulmonary infection control time, respiratory intensive care unit (RICU) observation time and recovery time of patients in the study group were shorter than those in the control group (P<0.05). After treatment, the levels of raw air way (Raw) and peak inspiratory pressure (PIP) in two groups were lower than those before treatment, and the level of dynamic lung compliance (Cdyn) was higher than those before treatment, and the Raw and PIP levels in the study group were lower than those in the control group, and the Cdyn level was higher than that in the control group (P<0.05). After treatment, the level of arterial partial pressure of oxygen (PaO2) was higher than those before treatment, and the level of arterial partial pressure of carbon dioxide (PaCO2) was lower than those before treatment, and the level of PaO2 in the study group was higher than that in the control group, and the level of PaCO2 was lower than that in the control group (P<0.05). After treatment, the levels of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in two groups were lower than those before treatment, and the study group was lower than those in the control group (P<0.05). There was no significant difference in the incidence of complications between two groups (P>0.05). Conclusion In patients with severe ventilator-associated pneumonia, fiberbronchoscopy-assisted therapy can promote the remission of the disease, improve the indexes of blood gas and lung ventilation, and reduce the level of inflammation in vivo. The treatment is safe and worthy of clinical application.