Community-acquired pneumonia (CAP) is a common ailment in childhood, and can be associated with significant morbidity and mortality. The introduction of vaccines led to a decline in pneumonia hospitalizations, although gains have been offset by emerging challenges. In addition, appropriate antibiotic management is complicated by the inability and reluctance to perform invasive tests. This review explores the advances made, as well as the new challenges subsequently posed, in the management and prevention of CAP, with emphasis on vaccine-preventable pneumonia, specifically Streptococcus pneumoniae.