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Severe community-acquired pneumonia (SCAP) significantly threats the safety of children's lives. Long non-coding RNA (lncRNA) MANCR is overexpressed in lung adenocarcinoma (LUAD) tissue, promote the proliferation, invasion, and migration, decreased cell apoptosis of LUAD cells. This study aimed to detect lncRNA MANCR levels in pediatric SCAP, and explore the diagnostic and prognostic significance of MANCR in pediatric SCAP. The mechanism of MANCR was examined in a lipopolysaccharide (LPS)-induced cell model. Serum MANCR level was detected by RT-PCR in participants. The diagnostic and prognostic value of MANCR was analyzed via ROC and KM curves. LPS constructed the pneumonia cell mode. Cell viability and apoptosis were detected by CCK-8 and flow cytometry respectively. ELISA examined the concentration of inflammatory factors. Serum MANCR level was elevated in SCAP patients. High MANCR could predict SCAP from controls (AUC = 0.852, sensitivity = 0.727, specificity = 0.836). High MANCR level is a predictor for poor prognosis of pediatric SCAP (P