Background: Arrhythmias and disturbed cardiac conduction can exacerbate uncontrolled asthma. Asthma medications have been linked, either directly or indirectly, to irregular heartbeats. There are few data about risk of arrhythmia in asthmatic children. Objective: The aim of the present study was to assess occurrence of arrhythmia and conduction disturbances in hospitalized asthmatic children and to investigate the predictors and impact of arrhythmia. Patients and methods: A cross-sectional study was conducted in the Pediatric Chest and Pediatric Intensive Care unit of Zagazig University Children hospital. This study was conducted on 56 asthmatic children. In absence of documented spirometric measurements, diagnosis of bronchial asthma was relied on medical basis. Clinical diagnosis relied on the updated 2022 GINA Guidelines. Assessment of severity of acute exacerbation was based on British National Guidelines and updated 2022 GINA Guidelines. Results: There was significant increase heart rate in children with sinus tachycardia compared to other asthmatic children. Otherwise, there was no difference on other vital signs. There was no difference in serum electrolytes and occurrence of sinus tachycardia. There was no relation between treatment of bronchial asthma and occurrence of sinus tachycardia. Conclusion: Asthmatic children were at increased risk of developing sinus tachycardia. There were significant association between sinus tachycardia with increased heart rate, and reduced hemoglobin level.