Background: Respiratory infections pose a significant threat to immunocompromised patients, yet comprehensive data on their clinical characteristics, outcomes, and prognostic factors remain limited. Methods: We conducted a retrospective analysis of 250 immunocompromised patients diagnosed with respiratory infections at our institution. Patient demographics, infection characteristics, clinical outcomes, and potential predictive factors were analyzed using descriptive statistics, survival analysis, and multivariate Cox proportional hazards regression. Results: The cohort (mean age 52.4 ± 14.2 years, 60% male) primarily comprised patients with hematologic malignancies (45%) and solid organ transplants (30%). Bacterial infections were most common (65%), with Staphylococcus aureus (34%) and Pseudomonas aeruginosa (29%) as predominant pathogens. The 30-day overall survival rate was 70%. ICU admission was required for 40% of patients, and 25% needed mechanical ventilation. Multivariate analysis identified age (HR 1.8 per 10-year increase, 95% CI 1.3-2.5), hematologic malignancy (HR 2.3, 95% CI 1.6-3.2), and mechanical ventilation (HR 3.5, 95% CI 2.1-4.8) as independent predictors of mortality. Early administration of appropriate antimicrobial therapy was associated with reduced mortality risk (HR 0.5, 95% CI 0.3-0.8). Conclusion: Respiratory infections in immunocompromised patients are associated with high morbidity and mortality. Advanced age, hematologic malignancies, and mechanical ventilation are significant predictors of poor outcomes. Early appropriate antimicrobial therapy significantly improves survival, emphasizing the importance of prompt diagnosis and treatment in this vulnerable population.