Pneumonia remains one of the leading causes of illness and death among children, particularly in low- and middle-income countries. This review presents a comprehensive update on pediatric pneumonia, covering recent advances in etiology, clinical presentation, diagnostic tools, treatment strategies, and prevention efforts. We explore both traditional and emerging diagnostic methods, including the use of biomarkers like C-reactive protein and procalcitonin, molecular testing, and point-of-care lung ultrasound. Treatment approaches are discussed in detail, with a focus on appropriate antibiotic use, antiviral and antifungal therapies, supportive care such as oxygen therapy and fluid management, and newer interventions like high-flow nasal cannula therapy. Preventive measures, including the introduction and global rollout of pneumococcal, influenza, and RSV vaccines, are also emphasized. In addition, the review highlights ongoing challenges such as antimicrobial resistance, healthcare disparities, and the limited accessibility of advanced diagnostic tools in resource-poor settings. Finally, we outline research gaps and stress the need for strong public health policies, global collaboration, and continued innovation to reduce the burden of pediatric pneumonia and improve outcomes for children worldwide. Highlights Pediatric pneumonia continues to cause high morbidity and mortality, especially in low- and middle-income countries. Advances in diagnostics, including lung ultrasound, procalcitonin testing, and molecular tools, have improved early detection. Rational antibiotic use and stewardship programs are vital to addressing rising antimicrobial resistance. New preventive tools, such as pneumococcal, influenza, and RSV vaccines, play a key role in reducing disease burden. Health disparities and limited access to care remain major challenges, highlighting the need for policy reforms and global health initiatives.