Background: Community acquired pneumonia (CAP), is an important cause of childhood  mortality. Proadrenomedullin (ProADM), is a new regulatory peptide extracted from pheochromocytoma and is a precursor of adrenomedullin but a more stable form. Adult  studies found that ProADM is elevated in patients with pneumonia and it is found to be correlated with severity and complications. Also other studies investigated ProADM as prognostic marker for many diseases as sepsis,dengue shock and heart failure.  Objective: The aim of this study was to measure the levels of ProADM in children with CAP and to correlate its levels with the  severity and complications.  Methods: This  study was done  on 90 children (60 children were diagnosed as  having CAP and 30 age & sex matched healthy controls). All children were subjected to history taking, clinical examination and investigations ( chest x ray, Complete Blood Count, C-reactive protein,  serum levels of  ProADM by enzyme-linked immuno-sorbent assay ELIZA). Modified Respiratory Distress Assessment Instrument (RDAI) score was used to classify out cases into mild, moderate and severe. Results:  Serum level of ProADM was found to be higher  in CAP cases than in controls and the difference was statistically significant (Mean ± SD = 1.52±0.62 and 0.05±0.04 respectively). Also ProADM was found to be higher  in complicated  cases, (4 pleural effusion, 1 collapse, 1 pneumothorax )  than uncomplicated cases  and the difference was statistically significant (2.50±0.24 and 1.41±0.05) respectively. ProADM was increasing with increasing severity of pneumonia.  Cutoff point>2.2 nmol/l was the best level to distinguish between complicated and uncomplicated cases (P=0.01 , sensitivity100%, specificity 81.5% , positive predictive value 37.5% , negative predictive value 100% ). Conclusion:  level of ProADM was elevated in CAP patients than in controls and higher levels were found in severe and complicated cases.