Asthma is the most common chronic lower respiratory tract disease in childhood in the world. Although asthma management has been advanced and guidelines specifically fr childhood asthma have been introduced, acute exacerbations continue to occur and cause considerable morbidity on pediatric patients. Multiplicity and diversity of exacerbation triggering factors and their dependence on a constellation of other factors make the prevention of acute exacerbation challenging. Appropriate pharmacotherapy and achievement of adequate asthma control is important to prevent acute exacerbations. Since responses of patients to therapies vary considerably depending on their phenotype, it would be appropriate to individualize treatment regime for each patient. In order to achieve this, further researches of risk factors and pathophysiology of asthma exacerbation in children are necessary.