Pediatric status asthmaticus (PAS) is medical emergency which results in frequent admissions to emergency departments. It requires immediate recognition and management, and there is increasing number of admissions to pediatric intensive care units (PICU). Assessment of severity is based on clinical signs and symptoms. The three main pathophysiological determinants of PAS are inflammation, bronhoconstriction and mucus plugging. Regardless of the severit y of the status asthmaticus, all patients should be initially treated with inhaled beta agonists. Oral corticosteroids are used in children with mild status asthmaticus, and in those who have not received beta agonist therapy within the first few hours upo n arriving at the emergency department. In moderate to severe status asthamticus, systemic corticosteroids, inhaled ipratropium bromide, and intravenous magnesium sulfate are administered. In severe exacerbations, either intramuscular or subcutaneous adren aline or terbutaline may be given. In case of persistence or worsening of signs and symptoms of the disease, and a continuous need for oxygen therapy after treatment with bronchodilators and systemic corticosteroids, patient should be admitted to the hospi tal. Severely ill children with signs and symptoms of impending respiratory failure require admission to the PICU. PICU management involves the use of corticosteroids, aggressive treatment with bronchodilators, and close monitoring. The child is not discha rged from intensive care while signs of severe dyspnea, the need for high oxygen concentrations and the need for continuous beta agonists treatment, magnesium sulfate treatment, and cardiopulmonary monitoring of the side effects of previously mentioned dru gs are present. In rare cases, non invasive and invasive ventilation is used. Non invasive ventilation is reserved for older children. Mechanical ventilation is reserved for patients whose condition, despite the conventional therapy, deteriorates toward re spiratory failure.