OBJECTIVE： To compare clinical efficacy and safety of budesonide and beclometasone assisting with terbutaline by atomization inhalation in the treatment of acute pediatric asthma attack. METHODS： 150 pediatric patients with acute asthma attack were randomly divided into group A and group B， with 75 cases in each group. Both group received symptomatic support treatment as low-flow oxygen inhalation， eliminating phlegm， relieving a cough， dilating bronchus and anti-infection， and atomization inhalation of ?budesonide， 1 ml each time， bid. Based on this， group A was given atomization inhalation of budesonide， 2 ml each time， bid； group B was given atomization inhalation of beclometasone， 2 ml， bid. Treatment course of 2 groups lasted for 7 d. Clinical efficacy， asthma control，PEF％ and the occurrence of ADR were observed in 2 groups； the time of symptoms and signs disappearance and hospitalization time were recorded， and symptoms and signs of children were scored 1 day before treatment and 7 days after treatment. RESULTS： During treatment， 2 cases and 3 cases were withdraw from the test in group A and group B， respectively. The total effective rates of group A and B were 91.78％ and 94.44％， and the rate of asthma control 95.89％ and 94.44％， without statistical significance （P＞0.05）. The time of breathing difficulties disappearance， cough disappearance time， wheezing disappearance time and hospitalization time of group A were separately （2.11±0.54）， （3.28±0.93）， （4.38±1.05）， （5.83±1.29）d； those of B group were separately （2.07±0.52），（3.30±0.96）， （4.45±1.08）， （5.90±1.33）d， there was no significant difference between 2 groups（P＞0.05）. The clinical symptoms and signs score of group A before and after treatment were separately （4.28±0.94） and （0.15±0.04）； those of before and after treatment of group B were separately （4.23±0.91） and （0.11±0.03）. There was significant difference before and after treatment （P＜0.05）， but there was no significant difference between 2 groups （P＞0.05）. The PEF％ of group A before and after treatment were separately （51.4±9.8）％ and （67.2±11.2）％； those of before and after treatment of group B were separately （52.0±7.1）％ and （68.3±8.7）％. There was significant difference before and after treatment （P＜0.05）， but there was no significant difference between 2 groups （P＞0.05）. No obvious ADR was found in 2 groups. CONCLUSIONS： Budesonide and beclometasone assisting with terbutaline by atomization inhalation in the treatment for acute pediatric asthma attack possess the same effects and can efficiently relieve symptoms and signs， increase the rate of asthma control and shorten the rehabilitation course with good safety.