Background: Asthma is a chronic disease that infect adults and children. It results in chronic symptoms of airflow obstruction. Developing and developed countries showed increase in asthma prevalence.The Saudi Initiative for Asthma (SINA) was developed in 2009 with attention to non-asthma specialists. Aim: To evaluate the knowledge and attitude of pediatric residents to Saudi Initiative Asthma (SINA) guidelines. Methods: This study is a cross sectional study included 153 residents from different residency levels. Results: The female participants represented 60.1%, while males represented 39.9%. There were 79% had low knowledge and 21 % had high knowledge. The prevalence of attitude represented 57.51%. Conclusion: Knowledge was low between residents, while attitude was moderate.