〔Abstract〕 Objective To study and explore the clinical therapeutic effect of montelukast sodium in children with asthma. Methods 78 children with asthma treated in Pingdingshan Fourth People's Hospital from June 2018 to June 2019 were randomly divided into natural group and research group, 39 cases in each group. Children in the natural group received conventional treatment, and children in the research group received montelukast sodium treatment on this basis. The asthma symptom score and pulmonary function score, urinary leukotriene monitoring level, blood oxygen partial pressure, blood carbon dioxide partial pressure, immunoglobulin E, eosinophil count and C-reactive protein level before and 6 months after treatment, occurrence of adverse reactions, cough relief time situation, wheezing relief time situation, wheezing disappearance time situation, the number of acute attacks of asthma, the number of emergency cases and the total effective rate of clinical treatment between the two groups were compared. Results The incidence of adverse reactions in the research group was significantly lower than that in the natural group (P < 0.05); The total effective rate of clinical treatment in the research group was significantly higher than that in the natural group (P < 0.05); Compared with before treatment, after 6 months of treatment, the asthma symptom score, urinary leukotriene monitoring level, blood carbon dioxide partial pressure, immunoglobulin E, eosinophil count and C-reactive protein level of children in the research group decreased significantly, and the pulmonary function score and blood oxygen partial pressure increased significantly compared with the natural group (P < 0.05); The cough relief time, wheezing relief time and wheezing disappearance time of children in the research group were significantly shorter than those in the natural group, and the number of acute attacks and emergency cases of asthma were significantly less than those in the natural group (P < 0.05). Conclusion Montelukast sodium has a good effect on children with asthma. It can not only improve the pulmonary function score, blood oxygen partial pressure and the total effective rate of clinical treatment, but also reduce the asthma symptom score, the incidence of adverse reactions, the level of urinary leukotriene monitoring, blood carbon dioxide partial pressure, immunoglobulin e, eosinophil count and C-reactive protein, shorten the cough relief time, wheezing relief time and wheezing disappearance time, and reduce the number of acute attacks and emergency cases of asthma.