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Acute respiratory infections (ARI) are a major public health issue in Mali. The objective of this study was to examine the management of ARI within the community among children aged 2 to 59 months. The study was based on a pilot community intervention over a period of 15 months (June 2008–August 2009) in 4 health districts in Mali. A survey was conducted two weeks before the intervention began in order to determine the incidence of ARI. During the intervention phase, 80 community healthcare workers and 1,123 mothers were trained, equipped and supervised, and 3,532 children aged 2 to 59 months were managed. Two healthcare areas were selected in each district. A “healthcare worker” area (where healthcare workers were trained and supervised) and a “mother” area (where mothers were trained and supervised) were randomly selected. Among the managed ARI cases, there were more cases of pneumonia in the mother areas (29.5%) than in the healthcare worker areas (24.9%) (p=.003). The study also found that the duration of the prescription period was more appropriate in healthcare worker areas (99.5%) than in mother areas (97.6%) (p=.03). In addition, the reduction in the incidence of complicated cases (before and after intervention) was more significant in mother areas (from 69‰ to 6‰, p=10 –6) than in healthcare worker areas (from 24‰ to 11‰, p=.01). The findings suggest that mothers with the appropriate training, equipment, and supervision are able to manage cases of ARI.