Human metapneumovirus (hMPV) has recently emerged as an important cause of lower respiratory tract infections in hospitalized children, causing severe pneumonia and respiratory failure among immunocompromised patients. We retrospectively examined 30 children diagnosed with cancer whose nasopharyngeal swabs were positive for hMPV by direct fluorescent testing over a 5-year period. In 16/30 (53.3%) children, infection was confined to the upper respiratory tract, whereas lower respiratory tract infection occurred in 46.7%. The median duration of respiratory illness was 6.5 days with a hospital admission rate of 66.6%. No mechanical ventilation was required because of hMPV infection. Bronchoalveolar lavage tested positive for hMPV in 1 patient requiring prolonged inhaled steroid and bronchodilator therapy. All children recovered completely from hMPV infection. hMPV causes upper and lower respiratory tract infections in immunocompromised children. Infections may result in significant disease but is usually not fatal. In the absence of specific anti-viral drug, good symptomatic therapy appears to be the optimal therapy.