Abstract: Objective This study aimed to analyze the effect of fluticasone propionate combined with terbutaline and ipratropium bromide in the nebulized inhalation treatment of acute asthma in children. Methods 100 children with acute asthma attack admitted to the Outpatient Department and the Asthma Specialty Outpatient Department of Minhang Hospital Affiliated to Fudan University, and the Pediatric Outpatient Department of Xinzhuang Community Health Service Center from January 2024 to February 2025 were the research subjects divided into the study group and control group according to random number table method, with 50 cases in each group. The control group was treated with prednisone acetate tablets combined with terbutaline and ipratropium bromide, while the study group was treated with fluticasone propionate combined with terbutaline and ipratropium bromide, with both groups being treated for 7 days. The clinical efficacy after 7 days of treatment, pulmonary function, concentration of alveolar nitric oxide（CaNO）, exhaled nitric oxide（FeNO） and clinical symptom scores between the two groups before and after 7 days of treatment, and the time for clinical symptoms to disappear and adverse reactions were observed. Results After 7 days of treatment, there was no difference in total effective rate between the two groups（one-sided P ＞ 0.05）. Before treatment, there was no differences in pulmonary function, CaNO, FeNO and clinical symptom scores between the two groups（two-sided P ＞ 0.05）; after 7 days of treatment, the lung function indexes of both groups increased, and the levels of CaNO and FeNO decreased, with no difference between the two groups（two-sided P ＞ 0.05）; the daytime and nighttime clinical symptom scores of both groups decreased after treatment, with no difference between the two groups（two-sided P ＞ 0.05）. The disappearance time of clinical symptoms in the study group was earlier than that in the control group（two-sided P ＜ 0.05）. The incidence of adverse reactions in the study group was lower than that in the control group（one-sided P ＜ 0.05）. Conclusion Fluticasone propionate combined with terbutaline and ipratropium bromide is highly effective in the treatment of acute asthma in children, which can improve lung function, reduce CaNO and FeNO levels, shorten the time for clinical symptoms to disappear, and reduce adverse drug reactions.