A programme was initiated to study pressure ulcer (PU) risk factors in a large, mixed intensive care unit and to reduce intensive care-acquired PUs (ICaPUs). All adult patients treated in 2011–2015 (n=8,336) were included in this retrospective observational cohort study. The characteristics of patients with PUs present on admission, ICaPUs or no PUs were analysed. The modified Jackson/Cubbin (mJ/C) risk score and length of stay were used to assess the PU risk and severity of illness. The measures to prevent ICaPUs seem to be effective in spite of an increasing risk for PUs.