Aim: This study was investigating the effect of prescribing zinc sulphate on improving the clinical symptoms of pneumonia in children below 60 months of age. Material and Methods: This Case-Control study was done the Department of Paediatrics, Nalanda Medical College and Hospital, Patna, Bihar, India for 12 months. Among 300 patients divided into two equal groups. 150 Children between the age of 2 months to 59 months and children with Acute Lower Respiratory Tract infection were included in case group and 150 children for control group. The details of blood investigations and imaging for confirmation of clinical diagnosis were also noted during the stay of the patient in the hospital. The serum zinc estimation was done by using colorimetric test. Results: The mean age of cases was 1.63±1.44 yrs and that of controls was 1.77±1.85 yrs. The Sex wise distribution of the cases and controls consisted of 91(60.67%) of cases being male and 59(39.33%) being female as compared to 87(58%) of controls being male and 63(42%) being female. The Mean serum zinc levels in the cases and controls, after comparison, were found to be significantly different [p=0.0001], with mean value for the cases being 58.98 ± 10.22 ug/dl as compared to 85.12 ± 12.12 ug/dl for the controls. A total of 42 cases and controls (28%) were found to have deficiency of zinc, of which majority (89.29%) were cases. Severe Pneumonia group (Mean=39.95±5.98ug/dl) having significantly lower value than that of Pneumonia group (Mean=63.78 ±6.76 ug/dl). According to oxygen requirements, with cases managed on room air having mean of 66.11±7.22 ug/dl, cases requiring supplemental oxygen by nasal prongs having mean of 63.23±10.29 ug/dl and cases requiring mechanical ventilation having mean of 41.17±7.88 ug/dl(Table 3). The serum zinc analysis of patients according to outcome shows significantly lower zinc values (p value=0.0001) in cases who eventually died due to the ALRTI and its complications (n=17) as compared to those who got discharged after treatment (n=133). Conclusion: we concluded that the low serum level of zinc was seen in severe pneumonia cases. Serum zinc levels were found to be lower in risk factors of LRTI like poor nutritional status, anemia, vitamin A deficiency, low birth weight and formula fed patients. Zinc supplementation is required in LRTI patients especially those with the above mentioned risk factors.