Bronchial asthma is a chronic airway disease with an underlying inflammatory component. Despite advances in modern medical care and the introduction of effective therapies, such as inhaled corticosteroids, poor asthma control exists in clinical practice. That can be attributed to two primary factors: (i) poor compliance and adherence to treatment; and (ii) poor efficiency of inhalation drug delivery, resulting from the inability of young children to correctly use inhalers . Free serum L- carnitine was not affected in 31 patients with mild acute athma attacks (group I) , while decreased in 30 patients with moderate acute asthma attacks (group II)as compared to 20 healthy children (group III). Giving L-carnitine as an adjuvant therapy to the conventional asthma treatment for 3 months resulted in:(i)Statistically significant increase in serum l-carnitine after 3 weeks and after 3 months (ii)Statistically significant reduction in the frequency of moderate and severe acute attacks during 3 months follow up (iii)Statistically significant improvement in pulmonary functions( FEV1, FVC and FEV1/FVC).