Background and objective: Pneumonia constitutes one of the major causes of worldwide mortality in young children. Poverty has been traditionally assigned as the underlying factor accounting for these trends. However, the independent role of solid fuel use yielding biomass pollution on pneumonia rates among young children has not been extensively examined. Methods: Independent socio-economic variables, and the percentage of solid fuel use, tobacco consumption, improved water access source and sanitation facilities were extracted for each country from the available public databases. Multivariate regression analyses were performed to assess potential associations between these recognized risk factors and country pneumonia incidence in young children <5years of age. Results: Multivariate linear regression analyses yielded two models that accounted for approximately 87% of the variance, and included solid fuel use, tobacco consumption, sanitation access, measles immunization, life expectancy, access to electricity and the Human Development Index (HDI) as being independently associated with the number of annual pneumonia cases per child <5years of age. Conclusion: In this ecological study, current country rates of pneumonia among young children are independently associated with the use of solid fuels. We postulate that interventions aimed at reducing indoor solid fuel biomass pollution through implementation of efficient stoves will translate into meaningful decreases in child mortality and morbidity.