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Cefiderocol use in <i>A. baumannii</i> pneumonia still represents an important matter of debate. The aim of this study is to describe 13 cases of carbapenem-resistant <i>A. baumannii</i> (CRAB) pneumonia treated with cefiderocol in real-life practice. We retrospectively included patients with CRAB pneumonia hospitalized at Fondazione Policlinico Universitario Agostino Gemelli Hospital treated with cefiderocol either in the general ward or the intensive care unit. A total of 11 patients out of 13 had ventilator-associated pneumonia caused by CRAB, and 12/13 patients had polymicrobial infection. We found a 30-day success rate of 54%. Cefiderocol may have a role when facing severe XDR <i>A. baumannii</i> pneumonia. Future studies are warranted to better define its place in therapy in CRAB infections.