Asthma is a common chronic disease among children in Taiwan. Acute asthma exacerbation is a cause of strong concern for children and parents and represents a challenge for pediatric healthcare providers. This review summarizes the most up-to-date information on assessing and managing acute asthma exacerbations in children. The latest guidelines (National Asthma Education and Prevention Program, Expert Panel Report 3, 2007 and the Global Initiative for Asthma, 2010) recommend using sensitive instruments to assess asthma exacerbation severity and administering early treatment in order to avoid emergency outpatient visits and hospitalizations. SABA (short acting β-agonist) in combination with systematic cortisone is the most widely prescribed pharmaceutical intervention for acute asthma management. Other pediatric asthma medications are still in the trial stage. Educating parents on self-management techniques, especially with regard to the correct application of asthma medication on children, is crucial to reducing relapse incidents and visits to the emergency ward. Nursing studies addressing the issue of asthma exacerbation in children and parents are currently at the initial, qualitative stage. More evidence-based studies are necessary to explore and understand the independent role and function of nurses in acute pediatric asthma care.