Severe pneumonia is one of the major causes of childhood morbidity and mortality. The information in severe pneumonia is limited and its management with initial empirical antibiotic treatment is still under discussion. This project could provide recent information about the prevalence, factors contributing to high mortality and the treatment management among children under the age of twelve years. Immunization has enormous potential to reduce the burden of childhood death with severe pneumonia. Different antibiotics and other drug treatments should be given based on laboratory results. To identify the causative agent and its sensitivity to specific drug, applying drug sensitivity test is mandatory. It can also reduce the emergency of drug resistant microorganisms. Particular attention should be given to the selection of therapy.