Three childhood cases of beta-hemolytic streptococcal pneumonia are presented with a review of the literature. The disease, though uncommon in childhood, results in severe local and systemic effects. Hematologic fluid and electrolyte problems are frequent. Pericardial disease and secondary bacterial invasion are added dangers encountered in management. Early and vigorous drainage of the pleural cavity is essential to successful outcome. It appears that predisposing viral disease, including influenza, is essential for acquisition of this form of bacterial pneumonia.