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The study assessed the prevalence of pneumonia and associated factors in children under five years of age attendingpediatric ward at Ishaka Adventist Hospital and the specific objectives were to establish prevalence of the childrenpresenting with pneumonia among children, to identify the factors associated with occurrence of pneumonia inchildren under five and to review the clinical presentation of pneumonia in children under five years. A descriptivequestionnaire based cross sectional study was to be carried out in Ishaka Adventist hospital, whereby attendants ofchildren of below five years but above 3 months on pediatric ward were requested to participate in the study. Aftera laboratory follow up and comparison with patients file will be done to confirm the diagnosis. The study found outthat, Children who participated in this study were 138, out of which 24(17%) had pneumonia, those who were mostinvolved in this study were between age of 3months- 2years 98(71%). Also, the highest age range of children withpneumonia were 3month- 2years 19(79%) and the most factors associated with pneumonia in this study werecrowded houses 01(7%), dusty houses 02(8%), one was not fully immunized (7%) and parents’ smoking was 01 (7%)and lastly the most clinical features presented in children who had pneumonia were cough 8(33%), flue 05(20.8%)and fever 04(16.7%). In conclusion therefore, although different measures have been taken intervene in treatment ofpneumonia, it is not enough and therefore the following are recommendations, health workers should health educateabout the importance of immunization during antenatal so that after birth, mothers already know how to preventpneumonia, during out reaches, health workers should advice parents on good ventilation, avoiding children to reachfire place were smoke can find them and lastly health workers should educate mothers/ caretakers on early signsand symptoms so that if seen in children, can be brought for treatment to avoid complication.