Abstract. Pneumonia is an acute respiratory infection with high morbidity and mortality in children under 5 years of age, especially in developing countries. One of the risk factors for pneumonia is nutritional status. The objective of this study was to know the relationship between nutritional status and severity of pneumonia in under-five patients hospitalized at Al-Ihsan Hospital. The research design used an analytic observational method with a cross-sectional approach. Data was taken from the medical records of pediatric pneumonia patients at Al-Ihsan Regional Hospital for the period January 2017-September 2020. The total subjects were 47 children aged 2-59 months who met the inclusion and exclusion criteria. The Nutritional status was determined based on the WHO Child Growth Standard (WCGS) reference weight/age index, while the severity of pneumonia is determined based on WHO criteria. The results showed that most children under five in this study had good nutritional status (74.5%), the children under 5 years of age with good nutritional status mostly experienced pneumonia severity (68.1%), and children under 5 years of age with underweight and severely underweight mostly experienced severe or very severe pneumonia (17.0%). Bivariate analysis with Chi Square showed a relationship between nutritional status and the severity of pneumonia in under-five patients hospitalized at Al-Ihsan Hospital (p<0.05). Children under 5 years of age with underweight and severely underweight can increase the severity of pneumonia.Keywords: Degree of pneumonia, nutritional status, under-five childrenAbstrak. Pneumonia merupakan infeksi saluran pernapasan akut dengan morbiditas dan mortalitas cukup tinggi pada anak usia di bawah 5 tahun, terutama di negara berkembang. Salah satu faktor risiko dari pneumonia adalah status gizi. Tujuan penelitian ini untuk mengetahui hubungan status gizi dengan derajat keparahan pneumonia pada pasien balita rawat inap di Rumah Sakit Al-Ihsan. Desain penelitian ini menggunakan metode observational analitik dengan pendekatan cross-sectional. Data diambil dari rekam medis pasien pneumonia anak di RSUD Al-Ihsan periode Januari 2017–September 2020. Total subyek penelitian berjumlah 47 balita berusia 2-59 bulan yang memenuhi kriteria inklusi dan eksklusi. Status gizi ditetapkan berdasarkan indeks BB/U rujukan standar grafik pertumbuhan anak WHO, sedangkan derajat keparahan pneumonia ditentukan berdasarkan kriteria WHO. Hasil penelitian menunjukkan sebagian besar balita dalam penelitian ini memiliki status gizi baik (74.5%), balita dengan status gizi baik sebagian besar mengalami derajat keparahan pneumonia (68.1%), dan balita dengan gizi kurang dan buruk sebagian besar mengalami derajat keparahan pneumonia berat atau sangat berat (17.0%). Analisis bivariat dengan chi square menunjukkan terdapat hubungan antara status gizi dengan derajat keparahan pneumonia pada pasien balita rawat inap di Rumah Sakit Al-Ihsan (p<0,05). Balita dengan status gizi kurang dan buruk dapat meningkatkan derajat keparahan pneumonia.Kata Kunci: Balita, derajat keparahan pneumonia, status gizi