In cases with recurrent pneumonia-It is crucial to identify the underlying cause to provide appropriate treatment and prevent further complications. However, challenges in immunodeficiency testing pose significant obstacles in accurately diagnosing and managing this condition. One major challenge in immunodeficiency testing is the lack of standardized protocols and knowing the type of test for the phenotype of patients. Some immunodeficiencies are difficult to detect using conventional tests and may require specialized assays or genetic testing, which are mostly not readily available in all healthcare settings. Additionally, false-negative or positive results are common in immunodeficiency testing. Addressing these challenges requires collaboration between the respiratory physician and immunologist to develop standardized protocols for testing and improve access to advanced diagnostic tools. By overcoming these obstacles, accurate diagnosis and management of recurrent pneumonia associated with immunodeficiencies can be achieved, leading to better patient outcomes.