Pneumonia remains a leading cause of morbidity and mortality worldwide. It remains the third leading cause of death worldwide. In the US, the disease is responsible for 1.1 million adult hospitalizations and 50,000 deaths each year. It is the most common antecedent to sepsis, occurring in nearly 50% of patients admitted with pneumonia, and the most common single cause of acute respiratory distress syndrome (ARDS). 10% of all hospitalizations for pneumonia lead to an ICU admission. Strategies have focused on early antibiotics and recognition of sepsis to reduce morbidity and mortality. In this chapter we will examine the role of adjuvant corticosteroids in the management of pneumonia.