Aeromonas hydrophila sepsis and pneumonia are rare diseases in children that carry a high mortality rate. We report a case of fatal bacteremic pneumonia caused by A. hydrophila in a previously healthy 5-year-old child. The source of infection was not determined and the child died within 4 hours of admission. In children who develop a fulminant disease of pneumonia with or without sepsis, particularly those who have underlying medical conditions, a possible A. hydrophila infection, though rare, should be considered. More reported cases are needed to establish the epidemiologic features of this disease in children.