Lower respiratory infections (LRIs) continue to threaten the health of children worldwide and are exacerbated by global environmental problems such as air pollution [1]. In the developing world where nutrition remains poor and access to healthcare is scarce, LRIs are the most common cause of illness and death in children. Outcomes of LRI illness are far better in developed countries, but the overall morbidity of LRI is still high and may exceed that of other age groups [2]. The environmental "health" of our planet remains an issue closely linked to the health of children--particularly in terms of LRI disease. It is also clear that further progress in preventing, diagnosing, and treating LRI disease will have a significant impact on the health of children. The recent literature details both progress and clinical dilemmas of LRI-related illnesses in children. Lower respiratory infection disease is considered to include the following entities: acute lower respiratory infections, pneumonia, atypical pneumonia, bronchitis, and bronchiolitis. This update will review current reports on the evaluation of children with LRIs, bacterial and viral LRIs, and sequelae of LRIs.