Many patients have incorrect aerosol inhalation technique with metered dose inhalers (MDI). Several inhalation aids have been developed and marketed for these patients. Even those who have correct inhalation technique may benefit from these devices. We compared bronchodilator efficacy of two puffs of albuterol aerosol administered either directly from a MDI mouthpiece, or from an inhalation aid (InspirEase, Aerochamber, Aerosol Bag) in 20 children who had previously demonstrated proper inhalation technique. The children received two puffs of aerosol from a MDI in each of two modalities tested each day on four different days (double blind). One modality contained albuterol aerosol and the other placebo. Pulmonary function was tested before and at 15, 30, 60, 120, and 180 minutes after treatment. Forced expiratory volume in 1 second (FEV1) increased similarly after all four modes of administration. Six patients who had incorrect inhalation technique benefited from the three inhalation aids. The aerosol bag and InspirEase produced slightly greater bronchodilator response than the Aerochamber. The inhalation aids are useful devices for those who have incorrect inhalation technique, but those who have correct technique do not derive any benefit from these devices.