Background: One of the core ingredients of the Integrated Management of Childhood Illness (IMCI) strategy is controlling children respiratory infection (ARI). The implementation of this policy makes it possible to manage respiratory infection. More than 10% (14%) of the Egyptian children had ARI according to Egyptian Demographic Health Survey (EDHS) 2014. Objectives: The present study aimed to describe the management of acute respiratory infections according to IMCI strategy in an urban MCH Center. Methods: A cross-sectional study was conducted at Kedwany MCH Center in Assiut city, Egypt. Exit interviews with the caregivers of 300 children diagnosed with acute respiratory tract infections were done using semistructured questionnaires. Three inventories were conducted emphasizing the availability of IMCI-recommended drugs, vaccines, and equipment at the center. Data were collected from the IMCI records during the study period. Results: According to IMCI classification, 12.7% of the studied children had pneumonia/cough or cold and 87.3% of them had not. Prescription of ARI treatment was done for 99.7% of cases and all of them were accurate; 84.3% of children received cough syrup and 42.7% received antibiotics. All of the checked records were filled according IMCI guidelines. The center was well equipped and supplied by requirements. Conclusion: 73.7% of the studied children suffering from acute respiratory tract infections were of age less than 2 years. The IMCI-recommended drugs, equipment, and vaccines were available at the study center. Healthcare providers should give emphasis to children caregivers about the signs and symptoms of respiratory infection indicating their need for immediate return for follow-up.