Understanding the main risk factors can help develop preventive strategies with a geographical focus. The objective of the current observational study was to gather data on the factors of risk for severe lower respiratory infections (ALRI) in children under the age of five who were hospitalized in Mumbai, India. A transactional observational study for case-control was conducted at Dr. Agarwal’s children hospital, Mumbai from September 2022 - November 2022 in 100 ALRI hospitalized below-5-year-old children along with 100 healthy newborns who were simultaneously picked from the immunization and well-baby clinics as controls. In this study, a hierarchy of the ALRI risk factors is made clear., immunization, improper breastfeeding and weaning techniques, poor living conditions and hunger, prematurity, and caesarean birth. The first year of life turns out to be the most susceptible time in this regard. The study's definition of risk variables, though it uses a different hierarchical pattern, is consistent with prior publications. Adequate prenatal and vaccination care, good nutrition and breastfeeding support, limiting crowding, and avoiding infection from contacts with family members emerged as major preventative concepts. In a particular geographical context, efficient health education and accessibility to fundamental child and maternal health services, particularly for preterm and young infants, appeared to be necessary preventive measures against ALRI in preschool infants.