Pneumonia is a common childhood respiratory disease. “Ineffective airway clearance” is the major nursing problem. In this case study, due to the right middle lobe lung infiltration, this hospitalized child experienced frequently ineffective cough and did not able to expel sputum smoothly; therefore, we designed a series of therapeutic play to increase lung expansion of this child. For development theories of school-age child and the favorite sports game and drawing of the child consideration, we combined instructional, physiologically enhancing, and emotional play to design a three-level game named “Breaking through the Barricade”. First, the initial game was health education by flipchart of lung (using cartoon pictures of bacteria sticking onto the flipchart to illustrate the cause and effects of pneumonia). The second game was “football game by mouth” (goaling by blowing the hand-made tiny soccer). The third game was “creative blowing paint”. We encouraged the child to practice diaphragmatic breathing and pout expelling repeatedly, then to set behavior contract with him (blowing football game every day at least 10-15 minutes to collect points for a special award). These games were designed to strengthen the deep breathing skills, which continue to be performed by his mother and him after returning home. In midst of the evaluation of this therapeutic play by return demonstrations, we found the patient had a huge progress on performing diaphragmatic breathing and pursed lips breathing. In the beginning, the child coughed 3-4 times every 30 minutes ineffectively; but after the practice, he coughed effectively 1-2 times every 30 minutes. The effectiveness of applying therapeutic play to promote lung expansion has been approved. This case study applies the principles of “atraumatic care”, and invites the family to join this process. Moreover, an appropriate and specific behavior contract also contributed to promote persistent lung expansion and effect recovering from ineffective airway clearance.