Asthma is an allergic disease characterized by chronic airway hyperresponsiveness, which has a great impact on the physical and mental health of children, their families and society. In asthma control, glucocorticoids are considered to be one of the most effective drugs, which can effectively inhibit the activity of immune cells in the airways and reduce the secretion of inflammatory substances. In the past, dexamethasone was commonly used to control asthma attacks in children with moderate to severe bronchial asthma, but now methylprednisolone has become the drug of choice for the treatment of moderate to severe bronchial asthma attacks in children. Methylprednisolone has strong anti-inflammatory, immunosuppressive and anti-allergic activities. Compared with other glucocorticoids, this drug has fast onset of action, precise efficacy and mild side effects. Methylprednisolone is a synthetic glucocorticosteroid, which is a medium-acting glucocorticosteroid. Its pharmacokinetics is primary, with a plasma half-life of 2.3-4 hours and a biological half-life of 12-36 hours, and is metabolized by the liver and mostly excreted in the urine. Generally, bronchospasm can be improved 1 to 2 hours after use, while it takes 4 to 6 hours for glucocorticoids such as dexamethasone to take effect. Methylprednisolone has a weak effect on sodium retention and has a short inhibitory time on the hypothalamus—pituitary—adrenal axis. Methylprednisolone has a strong inhibitory effect on the human immune system, has a variety of effects such as anti-lipid peroxidation, stabilizing lysosomal membranes, inhibiting the release of protein hydrolases, increasing local blood flow and promoting the outward movement of calcium. Methylprednisolone 10-5 mol/L can inhibit the degranulation of 20% of normal density eosinophils and 10-4 mol/L can inhibit the degranulation of 30% of lower density eosinophils. In regulating Th1/Th2 cell balance, it has been reported that methylprednisolone is more advantageous than dexamethasone, which may inhibit Th2-like cytokine production or increase the synthesis of Th1-like cytokines to correct abnormal humoral immunity in asthma to control asthma attacks. In the course of clinical application, it was experienced that the efficacy of methylprednisolone in treating moderate to severe bronchial asthma attacks in children was significantly better than that in the control group, and there were no significant toxic side effects. It is worth noting that the dose of methylprednisolone needs to be further explored, and the current recommended dose is 2 mg/kg times three times a day, which is reduced after three days. In conclusion, the present data show that the efficacy of methylprednisolone in the treatment of moderate to severe bronchial asthma exacerbations in children is positive and worthy of clinical promotion.