OBJECTIVE： To observe therapeutic efficacy and safety of budesonide aerosol inhalation for pediatric acute asthma attack. METHODS： Ninety patients diagnosed as acute asthma attack selected from our hospital during Jan. 2014-May 2016 were divided into observation group and control group in accordance with random number table， with 45 cases in each group. Control group was given Potassium sodium dehydroandroandrographolide and sodium chloride injection 10 mg/（kg·d），ivgtt，qd+Azithromycin injection 10 mg/（kg·d），ivgtt，qd for anti-infective therapy. Observation group was additionally given Budesonide aerosol 0.5 mg， aerosol inhalation， bid. Both groups received treatment for consecutive 7 d. Clinical efficacy， lung function index， T cell subgroup， symptom relief time were observed， and the occurrence of ADR was recorded. RESULTS： Total response rate of observation group （91.11％） was significantly higher than that of control group （71.11％）， with statistical significance （P＜0.05）. After treatment， FVC， FEV1 and FEV1/FVC of observation group were significantly higher than those of control group， with statistical significance （P＜0.05）. CD3+， CD4+ and CD4+/CD8+ of observation group were significantly increased， while CD8+ was decreased significantly； above indexes of observation group were improved significantly compared to control group， with statistical significance （P＜0.05）. The time of symptom relief as wheezing， coughing， difficult breathing and lung wheeze in observation group were significantly shorter than in control group， with statistical significance （P＜0.05）. There was no statistical significance in the incidence of ADR between 2 groups （P＞0.05）. CONCLUSIONS： Budesonide aerosol inhalation shows significant therapeutic efficacy for pediatric acute asthma attack with good safety.