As seen in several national registration systems, the morbidity and mortality due to pneumonia-related disease has increased in the Netherlands in the past 10 years. It is unlikely that the observed increase in mortality due to pneumonia is purely the result of the registration system used or misclassification. An increase in the elderly population is the most likely, albeit only partial, explanation. An increase in underlying diseases such as chronic obstructive pulmonary disease and diabetes mellitus is also a possible explanation. Increased antibiotic resistance, inadequate treatment or a shift in the spectrum of micro-organisms causing pneumonia are less likely explanations. Reducing the morbidity and mortality due to pneumonia demands an integrated approach aimed at elderly patients or patients with co-existing disease and executed by specialists in the fields of geriatrics, internal medicine, pulmonary disease and infectious diseases.