Pneumonia severity index (PSI) and urea, respiratory rate, blood pressure, age ≥65) are used to estimate the severity and prognosis of patients with pneumonia. NT-proBNP is a marker of myocardial stress and of sepsis-induced myocardial depression and might be used to predict short and long-term survival in patients with pneumonia. Twenty-three patients [age 79±15 standard deviation (SD); M/F 8/15, CURB-65 2.2±0.9 SD, PSI 118±38 SD, procalcitonin 3.9±5 SD] with pneumonia hospitalized in our Internal Medicine Unit were retrospectively evaluated. NT-proBNP was measured in the first 72 h of hospitalization. CURB-65 and PSI were calculated and correlation with biomarkers investigated. NT-proBNP showed a moderate statistically significant correlation with both PSI and CURB-65 (NT-proBNP vs PSI, r=0.42, P<0.05, NT-proBNP vs CURB-65, r=0.46, P<0.05). These correlations were confirmed also when patients with a diagnosis of heart failure where excluded from the analysis, even if the correlation did not reach the statistical significance. NT-proBNP seems to well correlate with the illness scores PSI and CURB-65 and might be a reliable predictor of severity and survival in patients with pneumonia.