Down syndrome (DS) is one of the most common hereditary human diseases and the most common chromosomal abnormality (trisomy of chromosome 21). Besides the typical appearance, multiple anomalies of the cardiovascular, central nervous and immune systems, gastrointestinal tract, locomotor system, patients with DS commonly have respiratory tract diseases. The article presents current literature data on the causes of recurrent respiratory infections, upper and lower respiratory tract obstruction and obstructive sleep apnea. It provides data on the consequences of such respiratory tract abnormality as tracheal bronchus. It also describes interstitial lung diseases with DS (pulmonary hypoplasia, subpleural cysts) and their association with congenital heart diseases and pulmonary hypertension. It presents observations of patients with DS and pulmonary subpleural cysts. It discusses Palivizumab use for severe respiratory syncytial virus infection in children with DS. © 2017, Pediatria Ltd. All rights reserved.