The availability of new diagnostic methods, a better understanding of asthma's pathophysiology, and the introduction of several oral and inhaled drugs have revolutionized asthma management in children. It has also increased the pediatrician's burden to keep abreast of the advances and educate them on the subjects. Children of 6-12 years coming to the department of pediatrics, who are Known asthmatic and children presented first time with symptoms suggestive of asthma, and exacerbation severity graded as mild, moderate& severe acute asthma exacerbation according to GINA 2019 guidelines, only children with mild and moderate exacerbation were selected in this study. The mean predicted PEFR improved with treatment by 20.82% from 50.68% to 71.5% of expected (p<0.0001) by 15 minutes. The mean PSI decreased by 2.84 (p<0.0001) from 4.8 to 2.0 by 15 minutes