Electronic nicotine delivery systems’ popularity has increased rapidly over the past decade among both adults and children and especially adolescents. With the growing number of consumers, the number of research studies describing the negative effects of e-cigarettes on the respiratory system and the so-called «E-cigarette or Vaping Use-Associated Lung Injury» (EVALI) is growing Worldwide as well. EVALI that occurs simultaneously with a lower respiratory tract infection can be considered as ‘probable EVALI.’ Addition of an infectious agent can be clinically manifested with the development of acute respiratory failure thus complicating the EVALI diagnosis. This Article represents a clinical case observation of an adolescent patient with mycoplasma pneumonia coupled with EVALI. © 2024, Pediatria Ltd.. All rights reserved.