In the present case- control study, measurement of VEGF level amongadmitted children suffering from community-acquired pneumonia (CAP)with or without parapneumonic pleural effusion was performed toinvestigate the role of VEGF in development of CAP and pleuraleffusion. The study was conducted on 41 children with CAP and 40 ageandsex-matched controls. Cases were subjected to a complete clinicalstudy and investigations were performed: CBC, chest x- ray, CRP, ESR inthe first hour, cultures (sputum / blood / pleural fluid if present) andserum VEGF. The study yielded the following results: serum VEGF wassignificantly elevated in cases when compared to controls (P = 0.006).There was a significantly elevated serum VEGF in patients withpneumonia and pleural effusion (n = 19) in comparison to patients withpneumonia without effusion (n = 22) (P = 0.017). There was a significantpositive correlation between serum VEGF and amount of pleural effusionin pneumonic patients (P = 0.001). The study concludes that VEGF mightplay a role in pathogenesis of inflammatory process and vascular leakageleading to development of effusion in pediatric pneumonia.