To study the possible relationship between vitamin A status and the severity of pneumonia, an analysis was made of serum retinol levels, conjunctival cytology, and clinical severity of the disease in 178 children admitted to a pediatric hospital in Havana for acute infectious pneumonia. The pneumonia was considered to be complicated (n = 57) when the patient presented pleural discharge, pulmonary abscesses, or both; if not, it was considered uncomplicated (n = 121). Serum retinol values in both groups were similar and were not found to be associated with the severity of the pneumonia. On the other hand, children with alterations in conjunctival cytology were twice as likely to have complicated pneumonia as those with normal cytology (relative risk = 2.2, with a 95% confidence interval of 1.1 to 4.5).