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Background Bronchial asthma is the most common chronic disorder in childhood, and asthma exacerbation is an important cause of childhood morbidity and hospitalization. Aim of the work It was to measure serum level of l -carnitine in children with bronchial asthma and to correlate its level with the severity of the disease. Subjects and methods This study included 3 groups. First group included 30 asthmatic children in acute attack, the second group included 15 children with stable asthma, and the third group (control group) included 10 apparently healthy children of matched age and sex with patients’ groups. The severity of the acute attack was determined according to pulmonary Score system. Serum l -carnitine levels and peak expiratory flow rate (PEFR) were estimated once in control group and stable asthmatics and twice in children with acute attack, the first during the attack and the second 3 weeks after the attack. Results Serum l -carnitine levels were significantly reduced in children suffering from acute asthmatic attacks than in the stable asthmatics and controls, while there was no significant difference between the latter two groups. Serum l -carnitine levels were not affected by the severity of the attack (no difference between mild and moderate attacks). On the other hand, l -carnitine levels were significantly reduced at the time of the acute attack than after 3 weeks of the attack. Conclusion According to our study, it could be concluded that l -carnitine decrease is linked to the occurrence of attack of bronchial asthma. Accordingly, it is recommended to make further studies to find out if there is a beneficial role of carnitine intake in the prophylaxis & treatment of attacks of bronchial asthma. The recommended studies should search for the most suitable dose & side effects of carnitine as a potential pharmaceutical agent.