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Background: Asthma is the most common chronic disorders of the respiratory tract. This study aimed to evaluate the effect of low-molecular-weight heparins (LMWHs) in the treatment of acute asthma., Methods: In this randomized clinical trial, patients with acute asthma attacks were enrolled. The patients were divided randomly into two groups. Patients in the intervention group received nebulized LMWH (1 mg/kg) with albuterol (2.5 mg) every 20 min for 10 min. The patients in the control group received nebulized albuterol with the same dose. Then peak expiratory flow rates (PEFR) and forced expiratory volume in 1 s (FEV1), and hemodynamic parameters in both groups were assessed for every 20 min., Results: In total 70 patients enrolled in this study. We found that the mean PEFR at 40 min was higher in the LMWH group than the control group (202.51 L/min and 180.2 L/min) (p = 0.001). Moreover, this difference remains significant in the 60th minute (p < 0.001). Further, FEV1 was significantly higher in the LMWH group after 60 min (1.82 L/min vs 1.48 L/min, p < 0.001). Moreover, we found that the hemodynamic parameters were sustainable in the intervention group., Conclusion: The study suggests that LMWH in mild-moderate asthma attacks may be beneficial in the short term and could be prescribed in addition to standard albuterol therapy., (Copyright © 2021. Published by Elsevier Ltd.)