We report the first two cases of community-acquired necrotizing pneumonia and bacteremia complicated by acute respiratory distress syndrome (ARDS) due to Panton-Valantine leukocidin-producing methicillin-resistant Staphylococcus aureus (MRSA-PVL) in Greece, together with a short literature review. Diagnosis was made by culture and broad spectrum PCR of respiratory secretions and blood. One patient received appropriate therapy and recovered fully. The other one died rapidly due to septic shock and life-threatening hemoptysis. Clinicians should be suspicious of community-acquired pneumonia due to MRSA-PVL strain, because rigorous microbiological diagnosis, early and appropriate therapy is essential for favorable outcome.