Lower respiratory tract infections in children are common and vary from relatively self-limited courses to life-threatening presentations. Recognition of disease patterns as they relate to age, sex, race, season, geography, environmental, and socioeconomic conditions is crucial in determining appropriate differential diagnosis and treatment strategies. The majority of children with respiratory infections will present to the primary care provider in an office setting and less frequently may require immediate referral from home or the outpatient setting to an emergency department. For children with recurrent or chronic respiratory infections, referral to a subspecialist may also be necessary. Primary providers are key in determining the extent of diagnostic effort, interventions, referrals, repeat evaluations, and in reinforcing treatment plans with children and their families.