〔Abstract〕 Objective To explore the peripheral red blood cell distribution width (RDW) and the level of total serum IgE in children with asthma and the value of clinical treatment guidance. Methods 78 children with asthma diagnosed and treated in the Second Invalides Hospital of Guangdong Province from January 2020 to March 2021 were selected as the observation group. According to the grading standard of asthma severity, it is divided into 4 levels: intermittent attack, mild, moderate, and severe. All children are treated with conventional methods. The 48 children with healthy physical examination during the same period are selected as the control group. The observation group and the control group The peripheral blood RDW and serum total immunoglobulin E (IgE) of children with different asthma severity in the observation group were compared. Results The peripheral blood RDW and serum total IgE levels of the observation group before treatment were higher than those of the control group; after treatment, the peripheral blood RDW and serum total IgE levels of the observation group were lower than before treatment, but still higher In the control group, the differences were statistically significant (P < 0.05); the peripheral blood RDW and serum total IgE levels of children with intermittent episodes were lower than those of mild, moderate and severe children; the RDW and serum total IgE levels of mild children The levels of RDW and total serum IgE in children with moderate and severe levels were lower than those in children with severe levels. The differences were statistically significant (P < 0.05). Conclusion Peripheral blood RDW and serum total IgE levels in children with asthma are higher. Both can reflect the severity of asthma in children, and can be used to guide clinical treatment and promote the recovery of children.