The goal of the present study was to compare the efficacy of nebulized vs powdered albuterol in patients with exacerbated bronchial asthma who required hospitalization. From January to May 1990 known asthmatics admitted with acute exacerbation were included by established criteria. Two groups were randomized. Group I for Albuterol powder 200 micrograms inhaled q 4 hours. Group II with Albuterol nebulized solution 2.5 mg inhaled q 4 hrs. Force Vital Capacity and Force Expiratory Volume in one second were measured with a pressure differential transducer upon admission, 30 minutes and 24-hours following therapies. Absolute FEV1 improvement was calculated. Statistical analysis was performed using student's T-Test and Fisher's exact Test with significance established at p > 0.01%. Fifteen patients enrolled in both groups, two patients of group I were excluded from the statistic analysis due to refusal to continue with the therapy. Both groups were comparable with respect to sex, asthma exacerbations/year, smoking history and hospital length of stay. FVC and FEV1 were comparable also. In contrast, there were significant difference when the absolute improvement were compared. The mean +/- SE for FEV1 absolute improvement at the first 30 min was 0.42 +/- 0.08 lts for the Group I versus 0.65 +/- 0.6 lts in the Group II. In the next 24 hours, Group I was 0.16 +/- 0.2 lts versus 0.30 +/- 0.7 lts in Group II (p > .01). We conclude that although the dose equivalence of both delivery systems have not been established in our study, the nebulized solution was more effective during the first 24 hours of hospitalization than the dry powder.