BACKGROUND : Pneumonia among under-five children is the leading causes of childhood morbidity and mortality. Clinical conditions at first time visited to emergency department influences the outcome of pneumonia.
OBJECTIVE : To identify clinical conditions and outcomes of pneumonia in children under-five years hospitalized during 2016-2018.
METHODS : A retrospective study to medical record during 2016-2018, collected 130 children under-fives who has been hospitalized with severe pneumonia in pediatric ward M. Djamil hospital. We identified initial clinical symptom, sign and laboratory data including breathlessness, fever, cough, cold, tachypnea, hemoglobin, white blood cell, immature to total neutrophils (IT) ratio, and chest X-ray. We defined the outcome by mortality rate and length of stay (LOS). Bivariate and multivariate analysis was done. 
RESULTS : We found 130 children under-fives years old whose fulfill inclusion criteria. The most of them were young baby <1 years old (74.62%),  57.69% were boys, complete basic immunization only 38.46%. Mortality rate about 4.1%  and no associations with initial clinical conditions. There was a relationship between getting breathlessness >1 day with length of stay (LOS) more than 5 days (adjusted OR 4.53, p=0.022). 
CONCLUSION : There were no associations between initial clinical conditions and mortality rate, however duration of breathlessness before hospitalized is associated with length of stay.