Our reviewed data demonstrated that Streptococcus pneumoniae (S. pneumoniae) is an important pathogen and death of pyogenic meningitis, pneumonia, and other infectious diseases in children. The distribution of serotypes of S. pneumoniae showed great diversity in several studies. The penicillin nonsusceptibility rates demonstrated an increase over time in China. The prevalence of resistance to erythromycin was very high. A total of 202 paraffin-embedded lung autopsy tissues of children aged 1 month to 5 years old who died of CAP were selected at random from a hospital. Conventional PCR, southern blotting and ISPCR were used to detect S. pneumoniae in lung tissues for a mouse pneumonia model and in 202 autopsy samples from fatal childhood CAP cases, 1 month to 5 years old, between 1953–2002. Southern blotting and ISPCR detected S. pneumoniae in 107/202 (53.0%) and 106/202 (52.5%) human samples respectively. A combined total of 116/202 (57.4%) samples were found to be positive by both methods. There is evidence that S. pneumoniae was an important cause of fatal childhood CAP in China, as elsewhere. Recently a total of 171 Streptococcus pneumoniae isolates causing invasive disease were isolated from Chinese children. The serotype distribution and antimicrobial resistance were tested. The results suggested that the 7-valent pneumococcal conjugate vaccine has a preventive effect among children and that there should be long-term surveillance for serotype 19A. Pneumococcal disease burden in China should be undertaken in the future to provide evidence and guidance to the use of vaccine and antibiotics in S. pmeumoniae infections.