The goal of mechanical ventilation is to achieve adequate gas exchange while minimizing haemodynamic compromise and ventilator-associated lung injury. Volume-controlled ventilation can be delivered via several modes, including controlled mechanical ventilation, assist control (AC) and synchronized intermittent mandatory ventilation (SIMV). .In volume-controlled modes, the clinician sets the flow pattern, flow rate, trigger sensitivity, tidal volume, respiratory rate, positive end-expiratory pressure, and fraction of inspired oxygen. Patient ventilator synchrony can be enhanced by setting appropriate trigger sensitivity and inspiratory flow rate. I:E ratio can be adjusted to improve oxygenation, avoid air trapping and enhance patient comfort. There is little data regarding the benefits of one volume-controlled mode over another. In acute respiratory distress syndrome, low tidal volume ventilation in conjunction with plateau pressure limitation should be employed as there is a reduction in mortality with this strategy. This chapter addresses respiratory mechanics, modes and settings, clinical applications, and limitations of volume-controlled ventilation.