OBJECTIVES: Community-acquired pneumonia (CAP) represents a considerable burden in senior adults in Russia. In adults >18 years, the incidence is ~280 per 100K, with >1% of treated cases resulting in death. The risk of CAP increases with increasing age and comorbidities. We assessed resource use and outcomes of CAP in Russia to characterize disease burden in Russian adults. METHODS: We conducted a retrospective chart review in a central Russian region of Tver for samples of 500 and 400 patients treated in inpatient and outpatient settings respectively.  All patients were 50 years of age and older and were not transferred from a hospital or previously hospitalized in the past 2 weeks.  Data were collected regarding age, gender, comorbidities, referral patterns, outcomes, resource use, employment status, and productivity loss. RESULTS:  Among inpatient CAP episodes the mean age was 65.9 years and 55.4% were male.  Most of the hospital admissions were referred by outpatient physician (63.4%), 25.4% were admitted by ambulance and 11.2% self-referred.  Among outpatient cases the mean age was 65.5 years and 52% were male.  Based on comorbidities, 75.0% of inpatient and 68.8% of outpatient cases were at moderate/high risk of pneumonia.  The overall length of stay among inpatient cases was 13.6 days.  Mean length of stay was similar across age groups and by risk categories. Outpatient cases received an average of 5 procedures, including one X-ray per case, and an average 8.4 days of antibiotic therapy.  Employed patients below retirement age comprise 12.8% and 18.3% of the inpatient and outpatient cases, respectively, and days lost from work per patient of working age was 8.0 (inpatient) and 7.0 (outpatient). CONCLUSIONS: CAP is a significant cause of healthcare utilization in adults in Russia.  Most CAP patients have chronic comorbidities.  Resource utilization was similar across age and risk groups.