OBJECTIVE Acute respiratory infection is a leading cause of morbidity and mortality in under five children in developing countries. Hence, the present study was undertaken to identify various modifiable risk factors for acute lower respiratory tract infections (ALRI) in children aged 1 mth to 5 yr. METHODS 104 ALRI cases fulfilling WHO criteria for pneumonia, in the age group of 1 mth to 5 yr were interrogated for potential modifiable risk factors as per a predesigned proforma. 104 healthy control children in the same age group were also interrogated. RESULTS The significant sociodemographic risk factors were parental illiteracy, low socioeconomic status, overcrowding and partial immunization, [p value < 0.05 in all]. Significant nutritional risk factors were administration of prelacteal feeds, early weaning, anemia, rickets and malnutrition, [p value < 0.05 in all]. Significant environmental risk factors were use of kerosene lamps, biomass fuel pollution and lack of ventilation [p value < 0.05 in all]. On logistic regression analysis, partial immunization, overcrowding and malnutrition were found to be significant risk factors. CONCLUSIONS The present study has identified various socio-demographic, nutritional and environmental modifiable risk factors for ALRI which can be tackled by effective education of the community and appropriate initiatives taken by the government.