Objective?To study the efficacy and safety of montelukast sodium combined with budesonide in the treatment of childhood asthma. Methods?A total of 240 asthmatic children admitted to Heze City Hospital of Shandong Province from December 2019 to October 2020 were selected as study subjects，and 120 asthmatic children were divided into control and observation group by random number table method. The observation group was treated with montelukast sodium combined with budesonide，and the control group was treated with budesonide. The effective rate，respiratory indexes and incidence of adverse reactions were compared between the two groups. Results?The total effective rate of treatment in the observation group was 95.00%，which was higher than the 80.83% of the control group（P ＜ 0.05）. FEV1 of the observation group was better than in the control group，while duration of wheeze and disappearance of dyspnea were lower than in the control group（P ＜ 0.05）. The incidence of adverse effects in the observation group was 10.00%，it was lower than the control group 26.67%（P ＜ 0.05）. Conclusion?Montelukast sodium combined with budesonide has a better clinical effect for the treatment of pediatric asthma，while reducing the incidence of adverse effects in children，increasing its safety profile and having the advantage of improving lung function.