Asthma is a chronic respiratory disease. Allergic airway inflammation is an important pathological basis for allergic asthma, and therefore control of this chronic inflammatory state is necessary for long-term control of asthma. Glucocorticoids are the most effective drugs to control allergic airway inflammation. As a chronic disease, the treatment of asthma requires long-term regular inhaled glucocorticosteroid (ICS), so will it affect the growth and development of children? In particular, will it cause precocious puberty, which is the concern of every parent. To answer this question, we must first understand what glucocorticoids are. First of all, the hormone we usually refer to is not a sex hormone, but a glucocorticoid, or “adrenocorticotropic hormone”, which is a type of steroid hormone secreted by the adrenal cortex and can also be synthesized artificially by chemical methods. It has the function of regulating the biosynthesis and metabolism of sugar, fat and protein, as well as inhibiting the immune response, anti-inflammatory, anti-toxic and anti-shock effects. In clinical work hormones are widely used in the treatment of bronchial asthma because of their strong anti-inflammatory and anti-allergic effects. Systemic glucocorticoids are generally used only for a short period of time during an acute asthma attack for rapid symptom control, usually within 1 week, and do not cause significant physical effects. Long-term hormone use refers to inhaled glucocorticoids (ICS), which are absorbed into the respiratory tract through inhalation and act directly on the bronchial tubes. During inhalation, more of the ICS is deposited in the oropharynx and swallowed into the digestive tract. This part of the ICS absorbed through the digestive tract first enters the liver via the portal vein, and most of it is metabolized by the liver – first-pass metabolism – and the proportion of it that actually enters the circulation and reaches the whole body is very small. As a result, ICS is a major breakthrough in the history of asthma treatment, providing a safe and effective treatment for asthma. The main adverse effects of ICS are oral fungal infections due to oropharyngeal deposition and hoarseness, the former of which can be resolved by rinsing the mouth, and the latter of which can be avoided by improving inhalation technique, changing the ICS dosage form, and inhalation device. Since ICS is not a sex hormone, it does not cause precocious puberty. In fact, the main focus of current ICS adverse effects is on its effect on height. A number of large, multicenter, long-term foreign studies have found that moderate doses of ICS inhalation can cause reduced growth rates in children within a few months of initiation of treatment and result in a 1-2 cm reduction in height, but do not affect final height in adulthood. Studies of the effects of longer inhalation doses of ICS on height are still ongoing. Several similar domestic studies have not found significant effects of ICS on height, weight, BMI, or bone age. Second, in clinical practice, physicians tend to use low-moderate doses of ICS for asthma, and the duration of treatment is shorter than abroad (generally around 2 years in China, 3-4 years or even longer abroad), thus theoretically having less impact on growth and development. In fact, there are many factors affecting height, including congenital genetic factors and acquired nutritional and disease factors, of which genetic factors are the most important, and if both parents are not tall, then there is no need to investigate why the child does not grow taller. Acquired factors play a role in promoting or inhibiting children’s height. Some studies have shown that children with frequent bronchial asthma attacks often suffer from sleep quality and growth hormone production, as well as malnutrition, which can affect growth and development. The use of ICS for asthma control, on the other hand, may improve these conditions and promote normal growth and development. Thus, inhaled glucocorticosteroids (ICS) are currently the drug of choice for long-term asthma control in children, and no evidence was found in a retrospective study abroad that ICS reduced final adult height, so ICS therapy is still the most effective and safe treatment for childhood asthma.