Background: Acute severe asthma is characterized by bronchospasm, marked airway narrowing, and significant respiratory distress. Intravenous magnesium sulfate (MgSO? )is increasingly used as an adjunctive therapy in acute severe exacerbations or life-threatening asthma in many countries, for patients do not respond adequately to first line therapy . Objective: To evaluate the effectiveness and safety of continuous intravenous MgSO? infusionin children with acute severe asthma in a pediatric intensive care unit (PICU) through a retrospective audit. Methods: A retrospective audit was conducted on 20 children aged 5–12 years admitted to thePICU with acute severe asthma. At presentation, all were unable to speak or feed due to breathlessness, with respiratory rates >30/min and heart rates >120/ min. None required intubation. Two had depressed consciousness, four were agitated, and the remainder wereconscious but distressed. All patients received intravenous MgSO? at 10–20 mg/kg/hour, continued for 1–4 days until clinical resolution of bronchospasm and respiratory distress. Clinical response and adverse events were reviewed. Results: Eleven children (55%) demonstrated marked clinical improvement within 24 hours, five(25%) required 48 hours of infusion, and four (20%) required up to four days of therapy . No significant adverse effects, including hypotension, arrhythmias, or hyporeflexia, were observed.Two children developed elevated serum magnesium levels without associated clinical toxicity . Conclusion: Continuous intravenous MgSO? infusionat 10–20 mg/kg/hour was effective and well tolerated in this cohort and the findings support its safe use.