Aim: This study aimed to determine the effect of adding nebulized magnesium sulfate to standard treatment in children with moderate to severe acute asthma attacks. 
 
 Methods: Pediatric patients admitted to the emergency department with moderate to severe asthma attacks were included in the study. The patients were divided into two groups. Group S received standard treatment, while Group M received nebulized magnesium sulfate in addition to standard therapy. 
 
 Results: A total of 129 patients were included in the study, 86 (66.7%) were male, and the median (minimum-maximum) age was 4 (2-8) years. When groups were compared, oxygen saturation at hour 1 was higher (p=0.024), and the PRAM (preschool respiratory assessment measure) scores at the 4th hour were lower (p=0.008) in the group that received magnesium sulfate. The groups had no differences regarding any of the other parameters at the 1st and 4th hours (p>0.05). 
 
 Conclusion: Adding nebulized magnesium sulfate to standard treatment in children with asthma attacks improves oxygen saturation faster and positively affects PRAM score at hour 4.