Aim. To reveal the clinical and morphological features and predictors of a fatal outcome in patients with community-acquired pneumonia. Materials and methods. The results of almost 6,500 autopsies were studied; out of them there were 1631 (25%) deaths from pneumonia: 134 and 1497 cases occurring at home and at hospital, respectively. Results. Both groups were considered in terms of pneumonia as a primary disease or as a fatal complication, with 6.4% having the former and 93.6% having a fatal complication of chronic obstructive pulmonary disease, chronic alcohol intoxication, cardiovascular diseases, or cancers. After negative prognosis assessment using the CURB-65 scale, pneumonia was rated as severe and requiring admission to the intensive care unit in 92% of the cases; PORT scale assessment showed that 60% cases of pneumonia necessitated hospitalizations to these units. The major clinical and morphological form of pneumonia was established to be disseminated, lobular, or overwhelming. Conclusion. In practice, risk factors for death are underestimated; the disease course is not monitored; current diagnostic and therapeutic approaches are inadequately applied.