Background: Pneumonia is the most frequent reason for morbidity and mortality in children worldwide. As many as ten times as many children die from childhood pneumonia in developing countries, compared to developed countries. Aim: This study was conducted to investigate severe recurrent pneumonia in children. Subjects and methods: This prospective & descriptive research were conducted on 200 patients at Tanta University Hospital, Pediatrics Department during the period from the beginning of May 2019 to April 2022. We recruited all patients with advanced recurrent pneumonia (RP). Results: Mean age of advanced RP children is 15.4 months, while the age at 1st episode of pneumonia was 12.7 months. Between children with advanced RP, the majority were males, being twice compared with females. Cough was the prevalent symptom in 99% of cases then wheezing (63%) and fever (60%). Respiratory abnormalities were the most prevalent (28%) as underlying causes of advanced RP patients, then immune disorders (22%) and congenital heart diseases (16%). The pulmonary hemorrhagic syndrome was the least prevalent cause as it was observed in only 2 cases. Conclusion: Children with underlying diseases had more serious diseases & poorer clinical results because they were more likely to get recurrent pneumonia & were susceptible to resistant microorganisms. As a result, more emphasis can be placed on clinical severity & therapeutic plan.