Probiotics are an established therapeutic or preventive intervention for gastrointestinal diseases and their efficacy is supported by several mechanisms, including the modulation of the immune response. However, there is evidence that the administration of probiotics may also be effective in the prevention or treatment of respiratory infections. Trials have been performed in general populations of infants and children and in populations at increased risk of respiratory infections, such as those in day care centers, schools, or hospitals, and evidence of a reduced rate of infections has been obtained in all those settings. In addition, the efficacy of probiotics to prevent respiratory infections has also been investigated in children with clinical conditions at increased risk of respiratory infections, such as those with atopy or with chronic diseases, and preliminary evidence of efficacy has been found. In adults, similar data have been obtained, although the body of evidence and the quality of data does not reach that available in childhood. Finally, the efficacy of probiotics in populations at risk of very severe respiratory infections, such as children with cystic fibrosis and preterm infants, has been investigated with promising results. However, differences in definitions, conditions, strains, and study protocols do not allow conclusions and further data are needed. In conclusion, probiotics provide a novel exciting opportunity for prevention and treatment of respiratory infections that is highly appealing in conditions of increased risk, particularly in children.Acute respiratory infections (ARI), including both upper respiratory tract infections (URTI) and lower respiratory infections (LRTI), are the most common illnesses during infancy worldwide. In developed countries, most children experience several respiratory infections (6-8 colds per year) in their first years of life. The common cold is also frequent in adults with an occurrence of 2-4 colds per year.Options for treatment of URTI are limited as it is prevalently of viral origin and generally based on symptoms. Probiotics have been proposed as therapy both in general settings and in populations at increased risk of URTI, which include conditions related to the host or to logistical conditions.