Mycoplasma pneumoniae is recognized as an important agent of pneumonia in pediatric population. In rare situations, severe pulmonary injury can develop. The use of corticoids in these cases remains controversial. A case of a girl with acute respiratory distress syndrome and bilateral pleural effusion secondary to pneumonia due to Mycoplasma pneumoniae is described, with good recovery after appropriate use of methylprednisolone and clarythromicyn.