Abstract: Pediatric ommunity-acquired pneumonia (CAP) is a significant infectious disease that threatens the health of children worldwide. Its extrapulmonary complications can affect multiple systems, significantly increasing the risk of severe disease and mortality. The pathogenesis of extrapulmonary complications in paediatric CAP is complex and diverse, with differences in the pathogenic mechanisms of different pathogen. The mutual promotion of immune-mediated damage and the inflammatory cytokine storm is a core pathological event leading to multisystem extrapulmonary complications in severe CAP. This article systematically reviews the epidemiological characteristics, pathophysiological mechanisms, risk factors, and diagnostic and therapeutic progress of extrapulmonary complications in paediatric CAP. It focuses on the characteristics of involvement and risk factors in the digestive, cardiovascular, neurological, haematological, and cutaneous-mucosal systems, and analyzes the early warning indicators of extrapulmonary complications in CAP caused by different pathogens, aiming to provide a reference for the early identification and precise intervention of extrapulmonary complications in paediatric CAP.