Abstract  Community-acquired pneumonia (CAP) is of predominant interest in analysing the burden of airway diseases. No population-based incidence data for children in Germany exist. In retrospective cohort studies from 1999 to 2001, parents of an entire age-class (28,000–30,000) of 5- to 7-year-old children at school entry medical examination (S1) in a complete federal state (Schleswig-Holstein, population 2.77 million) were interviewed by the Children and Adolescent Service of the Public Health Service. CAP was defined as pneumonia diagnosed by a physician at the time it occurred. The proportion of children investigated (participation rate) was 82.0–86.1%. The CAP-positive rate was 6.7–7.4%, 6.9–8.2% of whom had recurrent CAP. The mean age at first CAP was 36.4–39.4 months (median 42 months). This resulted in a population-based incidence for the age groups 0–1 year and 0–5 years (under 5) of 1,664–1,932 and 1,369–1,690 per 100,000, respectively; 93.7–95.9% received antibiotics. For each percent of CAP, 458 days (1999), 312 days (2000) and 319 days (2001) of at least one parent's work were lost, respectively. Conclusions: Despite a relatively weak case definition, the population-based incidence of CAP before school entry was the same as recently reported form California and about 30–50% of that reported 20 to 40 years ago in the USA and Finland.