ABSTRACT Background Lophomoniasis is an emerging respiratory infection, but its clinical and epidemiological characteristics in pediatric populations remain poorly defined. This study aimed to determine the prevalence and describe the clinical, radiological, and bronchoscopic features of lophomoniasis in children admitted to a pediatric respiratory referral center. Material and Methods A cross‐sectional study was conducted at Taleghani Pediatric Hospital. The study enrolled 121 pediatric patients admitted with persistent respiratory symptoms and a clinical indication for bronchoscopy. Bronchoalveolar lavage (BAL) samples were used to diagnose lophomoniasis. Results The frequency of lophomoniasis was 18.1% (22/121 patients). Mean age of lophomonas ‐positive patients was 8.03 years and they were primarily female (54.5%). Common presenting symptoms included cough (86.4%), fever (68.2%), and sputum (54.5%). Key findings included consolidation on radiography (54.5%), increased bronchial wall thickness on bronchoscopy (63.6%), and anemia (95.5%) in laboratory results. A significant majority (72.7%) had underlying diseases, most commonly cystic fibrosis (31.8%) and tuberculosis (13.6%). Statistical analysis revealed that lophomoniasis was significantly associated with the presence of any underlying disease ( p = 0.001). Other significant associations were observed with positive CRP ( p = 0.024), leukocytosis ( p = 0.025), radiographic consolidation ( p = 0.018), and the presence of a hydatid cyst ( p = 0.041). Demographic factors such as age, gender, ethnicity, and place of residence were not significantly associated with the infection. Conclusion Lophomonasis is a frequent condition among children with chronic respiratory symptoms requiring bronchoscopy. Its strong association with underlying respiratory diseases highlights the need for systematic screening in this vulnerable population. Bronchoscopy with BAL is a valuable diagnostic tool, particularly when specific clinical and radiological findings are present.