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COVID-19 pneumonia successfully managed with high-flow nasal cannula in a 15-year-old boy. We report an otherwise healthy, fully immunised 15-year-old boy who was transferred to our Pediatric intensive care unit with 4 days of fever, dry cough, increased work of breathing and impending respiratory failure. Two days prior, amoxicillin/clavulanic acid was prescribed for lower airway symptoms resembling pneumonia. PCR of the nasopharyngeal swab revealed an active COVID-19 infection (Ct 19). The CT scan showed significant ground-glass opacities highly associated with COVID-19 (COVID-19 reporting and data system 4). Antibiotics were continued and chloroquine was given for 5 days. High-flow nasal cannula (HFNC) was started as respiratory support therapy with rapid decrease of tachypnoea and oxygen demand. HFNC was successfully stopped after 7 days. The patient made full clinical recovery. This case illustrates HFNC as a successful respiratory support therapy in a paediatric patient with an active COVID-19 pneumonia.