Background:Acute respiratory infections (ARIs) are among the leading causes of outpatient morbidity worldwide. With increasing antimicrobial resistance and patient preference for integrative medicine, homeopathy has gained attention as a safe and effective complementary approach. The Boger–Boenninghausen’s Repertory (BBR) provides a concise and logical method for remedy selection in acute cases, emphasizing modalities, sensations, and concomitants. Objective: To evaluate the clinical efficacy of the Boger–Boenninghausen’s Repertory in managing acute respiratory tract conditions in a real-world outpatient setting. Methods: A prospective observational study was conducted from January to June 2025 across two Homoeopathic centers in Maharashtra, India. 100 patients aged 18–60 years with acute respiratory infections were enrolled. Detailed case taking, repertorization using BBR, and remedy confirmation through Materia Medica correlation were performed. Remedies were prescribed in 30C or 200C potencies based on susceptibility. Follow-ups were done on the 3rd and 7th days. Primary outcome: Reduction in symptom severity score. Secondary outcomes: Time to recovery, recurrence rate, and patient satisfaction. Results:Out of 100 cases, 88% achieved significant improvement within 7 days. Mean symptom score decreased from 8.4 (±1.2) to 3.2 (±0.9). The most commonly indicated remedies were Bryonia alba, Belladonna, Arsenicum album, Phosphorus, Hepar sulphuris, and Pulsatilla. No adverse effects were reported. Statistical significance: p < 0.001. Conclusion:The Boger–Boenninghausen’s Repertory is a clinically dependable tool in acute respiratory management, providing rapid improvement and reproducible results when applied with individualized case analysis.