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Background Bronchiolitis is an acute inflammatory obstruction of small airways in children that occurs in first two years of life and is characterized by fever, rhinitis, cough, tachypnoea, expiratory wheeze and increased respiratory effort. Objective To study efficacy of nebulized adrenaline compared with placebo in acute bronchiolitis. Methodology Quasi-experimental study carried out at Department of Paediatrics, King Edward Medical University/ Mayo Hospital, Lahore from October 2006 through March 2007. After consent from parents, sixty children of age between 2 months to 2 years with the first episode consistent with clinical case definition of bronchiolitis were included by using convenient sampling. Clinical scoring system was used to grade the severity of disease as well as to monitor the efficacy of intervention. Those having score =8 were randomly allocated to the two study groups. The information was recorded at 0 minute and effect of each method of treatment was followed for 90 minutes. Results Our study population was 60 children. The mean age was 11±6 months. Male to female ratio was 1.2:1. Mean weight of the children was 9±3 kg. Improvement in clinical score, oxygen saturation, and length of hospital at 0 and 90 minutes was noted in both groups but when compared with placebo, there was no statistically significant difference. Conclusion There is no difference in the efficacy of nebulization with adrenaline compared with placebo in the management of acute bronchiolitis. [ABSTRACT FROM AUTHOR]