Background: Pneumonia is the leading cause of death in children worldwide, causing 3.9 million deaths per year worldwide, of which 1.8 million children under the age of five years. Objective: The aim of this study was to define the role of lung ultrasound (LUS) in diagnosis of clinically suspected pneumonia compared to routine chest radiography. Methods: 224 children with suspected pneumonia were enrolled into the study. At baseline clinical summary suggestive of pneumonia and LUS were performed as well as chest radiography in one plane. Final discharge diagnosis was used as reference test. In and out patients with clinical features suggestive of pneumonia were enrolled. Results: Pneumonia was confirmed in 199 patients (88.80%). LUS revealed a sensitivity of 96.80% and specificity of 81.30%. 88.90% of the patients with pneumonia showed breath dependent motion of infiltrate, air bronchogram 92.90%, blurred margins 99.50% and polygonal shape in 97.50%. Discussion: Majority of the children (184/224) 82.20% were under five years. The sensitivity, specificity and positive predictive value of LUS was high and in line to previous studies. Conclusion: Based on sensitivity and specificity of LUS for evaluation of clinical pneumonia, LUS should be used in evaluation of clinically suspected pneumonia in children. Recommendation: LUS should be in the first line of investigations of pneumonia in children, combination with clinical features of pneumonia and positive LUS for pneumonia diagnosis can be established. Negative LUS does not rule out pneumonia, chest X ray or CT scan should be done. However chest radiography should be reserved for complicated pneumonia after LUS.