Abstract: OBJECTIVE To investigate the epidemiological features, clinical manifestations and pathogens of community-acquired pneumonia (CAP) in children. METHODS A total of 586 children who were diagnosed as CAP in Lianyungang First People's Hospital from February 2017 to February 2019 were enrolled. They were divided into 200 cases of infant group, 203 cases of young children group, 131 cases of preschool group and 30 cases of school-age group according to the age of children. The general situation questionnaire was designed to record the general data of children, examinations, auscultation results and the results of pathogen identification. RESULTS The range of age in 586 children with CAP was 1 month to 14 years old, mainly concentrated in 1 month to 3 years old. The investigation results of risk factors of CAP in children showed that the ratio of unclear predisposing factors in CAP children was high, accounting for 55.29%. Among 586 children with CAP, 243 cases had a history of food allergy/eczema, accounting for 41.47%. The CAP children were often accompanied by cough and shortness of breath. The fever symptoms in the infant group were relatively rare. They were with or without wheezing and diarrhea. Rashes were rare in all groups. Lung rale was the main sign of the disease, accompanied by wheezing. Myocardial damage was a common complication of the disease, and rotavirus enteritis mainly occurred in infants and young children. The positive detection rate of pathogen in 586 children was 62.29%, and a total of 479 strains of pathogens were detected. The main infection was viral infection, followed by bacterial infection and atypical pathogen infection. The detection rates of pathogens in infant group, young children group, preschool group and school-age group were 70.00%, 69.46%, 38.93% and 63.46%, respectively. The detection rate of pathogens in the preschool group was the lowest, which was lower than that in the other 3 groups (P<0.05). CONCLUSION CAP in children was mainly concentrated in infants and young children (≤3 years old). The cause of the disease is not clear, and the proportion of allergic constitution is relatively high. Cough, fever and shortness of breath were the main clinical features. The lung moist rale and wheezing rale in auscultation were the main signs. Viruses were the main pathogens of infection, and the distribution types of pathogens were various in different groups. It is necessary to pay attention to the clinical detection of pathogens and reasonable use of antibiotics in all ages.