Background: Asthma is a chronic airway disease characterized by inflammation of the airway, bronchospasm, and hypersensitivity to various stimuli. The standard treatment of asthma exacerbation is the use of inhaled short-acting β-2 agonists, systemic corticosteroids and supplemental oxygen. Nevertheless, every step of treatment is under debate and the search for the most effective management plan continue. Objective: To review the recent literature discussed the different ways of acute asthma exacerbation management in children. Method: A lot of literature have been done in order to provide better outcomes for patients presented with asthma, in our review we aim to discuss the recent literature that discussed asthma management in children. Conclusion: Oxygen should be used as carrier gas for intermittent or continuous nebulization. Frequent nebulization with β-2 agonist at the onset of an asthma exacerbation has been reported to be effective but some cases may require combination of salbutamol along with ipratropium for relief of obstruction. Also, nebulized MgSO4 is a well-tolerated bronchodilator for acutely ill asthmatic patients, and can be administered safely. Dexamethasone can be the preferred oral corticosteroid in the emergency management of pediatric patients with acute asthma exacerbations as an alternative of multi-day regimen of prednisolone in order to avoid non-compliance.