Chest infections are a diverse group of infections of the airways and lungs, the most common of which are pneumonia and acute bronchitis. A well-taken history and examination will often reveal the type of chest infection a patient has, guide the choice of antibiotics and reveal features that would prompt a referral to hospital. Many of these infections can be treated on an outpatient basis in the community. Some will need a referral for hospital admission or respiratory specialist review. This paper will cover an approach to history and examination in patients with symptoms of chest infection. Several validated tools to aid clinical decision-making will be covered and these provide evidence-based and useful guidelines to a busy family physician. This paper will also cover some current antibiotic guidelines, a patient’s journey through an emergency department visit, and some advice to patients on discharge.