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Aim: To study the effect of vitamin D supplementation in severity and control of bronchial asthma in children in Bihar region Methods: A cross-sectional, prospective study was conducted in the Department of pediatrics, Vardhman institute of Medical Sciences, Pawapuri, Nalanda, Bihar, India for 1 year, after taking the approval of the protocol review committee and institutional ethics committee. 53 asthmatic patients and 53 healthy controls were included in this study. The level of serum vitamin D in both groups was measured by radioimmunoassay (RIA) method at the reference lab and was categorized as sufficient (> 30 ng/ml), insufficient (20 to 30 ng/ml), or deficient (< 20 ng/ml). The severity of asthma was also stratified according to the asthma guideline into four grades of intermittent or mild, moderate, severe persistent. Results: Regarding rate of admission, 13.2% of patients were hospitalized once, 9.4% of patients were hospitalized twice, and 1.9% of them were also hospitalized three times. In the patients group and regarding the severity of asthma, 11.3% were classified as mild asthma, 45.3% as moderate asthma, and 43.4% as severe asthma. Also regarding control status of asthma, the disease was controlled in 18.9 %, partially controlled in 34.0 %, and uncontrolled in 47.2 %. According to the level of disease attack risk, 5 of 31 children aged less than 5 years (16.1%) classified as high-risk, while 7 of 22 children older than 5 years (31.8%) classified as high risk. Assessing the serum level of vitamin D showed that the asthmatic children had significantly lower level of vitamin D compared to normal cases (14.53 ± 8.10 ng.ml versus 22.45 ± 13.46 ng/ml, p < 0.001). Also, in the groups with and without asthma, the prevalence of vitamin D deficiency was 73.6 and 49.1%, and the prevalence of vitamin D insufficiency was 18.9 and 18.9 %, while normal vitamin D level was revealed in 7.5 and 32.1%, respectively with a significant difference (p = 0.005). In this regard, mean serum level of vitamin D in the patients with mild asthma was 12.85 ± 7.06 ng/ml, in the group with moderate asthma was 16.98 ± 8.63 ng/ml, in the patients with severe asthma was 12.42 ± 7.52 ng/ml, and in those with persistent asthma was 12.01 ± 5.00 ng/ml (p = 0.25). Conclusion: Vitamin D deficiency and insufficiency is a common finding among asthmatic children that may be associated by the physiological mechanism of this phenomenon. In fact, it seems that the use of supplement vitamin D can prevent progression of childhood asthma. [ABSTRACT FROM AUTHOR]