To assess the availability of laboratory tools for microbiological diagnosis of lower respiratory tract infection, a survey was conducted on a sample of Italian hospital laboratories during the period April-July 2005. Overall, 261 hospitals, one third of the total Italian hospitals, were randomly selected. All these laboratories were sent a standardized questionnaire collecting information on diagnostic tools available for testing a list of bacterial, viral and fungal organisms responsible for lower respiratory tract infections. Forty eight percent of the sample completed and returned the questionnaire. A part from few pathogens such as Enterobacteria, Enterococcus Pseudomonas aeruginosa, Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus pyogenes, Herpes simplex e Candida spp, for which no differences in diagnostic capacity among hospitals was found, for all the other pathogens considered, significant differences among geographical areas were found.