Background: Pneumonia remains the leading infectious cause of death among children worldwide. Zinc plays a crucial role by activating numerous enzymes participating in various metabolic and immune functions. Objective: To evaluate serum zinc levels in children hospitalized with pneumonia and to investigate the relationship between zinc concentrations, the severity of pneumonia, and patient outcomes. Patients and Methods: The study involved 120 children diagnosed with pneumonia, categorized into two groups based on their need for Pediatric Intensive Care Unit (PICU) admission: Group I: 45 children who required PICU admission, while Group II: 75 children who did not. Comprehensive medical histories, thorough clinical examinations, laboratory tests, radiological evaluations, and serum zinc measurements were conducted for all participants Results: Children admitted to the PICU had significantly lower serum zinc levels (62.8±26.7 μg/dL) compared to those not admitted (93.4±30.2 μg/dL), p < 0.001. Severe pneumonia, increased oxygen support, and mortality were associated with lower serum zinc levels. Serum zinc levels positively correlated with weight, height, BMI, hemoglobin, and blood pH, and negatively correlated with blood CO₂, C-reactive protein, and hospital stay duration. At a cutoff of <67.1 μg/dL, serum zinc was able to predict severe cases of pneumonia in children, with sensitivity of 83.1% and specificity of 74.3%. At a cutoff of <47 μg/dL, serum zinc was able to predict mortality in children with pneumonia, with 80.8% sensitivity and 73.2% specificity. Conclusion: A deficiency in zinc was linked to more severe cases of pneumonia, increased necessity for mechanical ventilation, higher mortality rates, and prolonged hospital stays.