OBJECTIVE: To evaluate the validity of the systolic blood pressure, oxygenation, age and respiratory rate (SOAR) score in predicting the need for mechanical ventilation, intensive care unit (ICU) admission and mortality up to 30 days in patients with pneumonia at high altitude. MATERIALS AND METHODS: An observational retrospective cohort study was performed with validity analysis for the following outcomes: 30-day mortality, need for mechanical ventilation and ICU admission in patients diagnosed with pneumonia, performed from 2015 to 2020 at a hospital at 2630 meters above sea level in the region of Cundinamarca, Colombia. RESULTS: A total of 471 patients were included in this study, the median age was 68.3 ± 19.1. Of these, 256 patients had a severe pneumonia diagnosis according to the SOAR score. The area under the receiver operating characteristic (ROC) curve of the SOAR score was 0.59 (IC95% 0.511-0.687; p = 0.029) for 30-day mortality, 0.50 (IC95% 0.43-0.56; p = 0.946) for the need of mechanical ventilation and finally 0.49 (IC95%: 0.43-0.54; p = 0.743) for ICU admission. 30-day mortality prediction had a 66.7% sensitivity and 46.9% specificity with a positive predictive value of 11.7% and negative predictive value of 93.9%. The cutoff value of the score was of 2. CONCLUSIONS: The SOAR score shows a moderate performance in the prediction of 30-day mortality in patients with pneumonia in high altitude environments. Additionally, it has no utility in the prediction of ICU admission and the need for mechanical ventilation in these patients.