Varicella is a common contagious infection in childhood with increasing incidence in adults. Pneumonia, although rare, is the most serious complication that commonly affects adults. Over the last two decades there have been major advances in the understanding of Varicella infections, management and prevention. This review discusses the epidemiology, pathogenesis, pulmonary manifestation, morbidity, longterm clinical consequences and current state of management of Varicella pneumonia in adults. Prevention and other disease-modifying therapy are also discussed.