Aim: This study was performed to estimation the relation between zinc deficiency and acute lower respiratory tract infections in children. Material and Methods: This Case-Control study was done the Department of Paediatrics, Nalanda Medical College and Hospital, Patna, Bihar, India for 1 years. Total of 220 cases and 110 controls were included in the study. The details of blood investigations and imaging for confirmation of clinical diagnosis were also noted during the stay of the patient in the hospital. The serum zinc estimation was done by using colorimetric test. Results: The mean age of cases was 1.59±1.38 yrs and that of controls was 1.86±1.77 yrs. The Sex wise distribution of the cases and controls consisted of 68(61.82%) of cases being male and 42(38.18%) being female as compared to 65(59.10%) of controls being male and 45(40.90%) being female. The Mean serum zinc levels in the cases and controls, after comparison, were found to be significantly different (p=0.0001), with mean value for the cases being 61.58 ± 10.92 ug/dl as compared to 86.89 ± 14.73 ug/dl for the controls. A total of 29 cases and controls (26.36%) were found to have deficiency of zinc, of which majority (88.18%) were cases (normal range of 60 to 150 ug/dl). Severe Pneumonia group (Mean=40.19 ± 5.69 ug/dl) having significantly lower value than that of Pneumonia group (Mean=64.12 ±6.88 ug/dl).This is also reflected when we see serum zinc levels according to oxygen requirements, with cases managed on room air having mean of 63.65 ± 6.87 ug/dl, cases requiring supplemental oxygen by nasal prongs having mean of 59.36 ±9.77 ug/dl and cases requiring mechanical ventilation having mean of 38.25 ±6.13 ug/dl (Table 3). The serum zinc analysis of patients according to outcome shows significantly lower zinc values (p value=0.0001) in cases who eventually died due to the ALRTI and its complications (n=15) as compared to those who got discharged after treatment (n=95). Conclusion: we concluded that the zinc deficiency occurs in the majority of recurrent respiratory infection in children and therefore a decreased serum zinc level is considered an additional risk factor for recurrent respiratory infection.