Background The Kingdom of Saudi Arabia (KSA) annually hosts more than three million Muslim pilgrims from around 184 countries during the Hajj pilgrimage. Respiratory tract infection (RTI) is a major public health challenge during the Muslim pilgrimage to Makkah. It is necessary to take health precautions among these pilgrims the uptake of health preventive measures among Hajj pilgrims from Saudi Arabia, bacteremia, otitis media, and bacterial meningitis, in addition to a significant cause of sinusitis, osteomyelitis, septic arthritis, endocarditis, and peritonitis. Complications of each of these diagnoses are common. Pneumonia is one of the leading causes of hospitalization and intensive care unit among pilgrims in Saudi hospitals during Hajj. During the 1986 Hajj season, pneumonia was the second most common cause of hospitalization with the highest case fatality ratio among those aged over 50 years, therefore pneumococcal vaccination is recommended. Clinical symptoms, signs and physical examination findings alone cannot differentiate pneumonia disease from infections caused by other pathogens,to our knowledge there is no study that has explored the knowledge, attitude, and practices related to pneumococcal infection and vaccination among all Hajj pilgrims in KSA