Pulmonary involvement in acute rheumatic fever is rare. Clinical and laboratory findings in rheumatic pneumonia are non-specific. Most of the cases of rheumatic pneumonia described in recent years have had a fulminant course often resulting in death. Autopsy findings are suggestive of but not specific for rheumatic pneumonia. In this article a case of pneumonia associated with acute rheumatic fever is described. Pneumonia and carditis occurred simultaneously in a 10-year-old boy treated without steroids, which resulted in recovery. The clinical spectrum of rheumatic pneumonia can range from mild to fulminant.