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Objective: The objective of this study is to compare the effects of inhaled beclomethasone with oral montelukast in long term management of moderate persistent asthma in children. Design: Quasi experimental study. Period: 6 months, from July 20,2007 to January 20, 2008. Settings: Out patient paediatric department at Fauji Foundation hospital, Rawalpindi. Material and Methods: 80 children between 5-12yrs of age presenting with moderate persistent asthma, divided in two groups of 40 each. Group A treated with beclomethasone inhaler while Group B was started on oral montelukast. Drugs effect was recorded on a 2 wkly proforma for 8 weeks. Results: There were 54(67.5%) male and 26(33%) female. Most common triggering factor seen in 54(67.5%) patients was recent history of respiratory tract infection, exposure to carpet dust in 43(53.75%), cigarette smoke in 42(52.5%),recent psychological stress in 28(35%) , pollen allergy in 26 (32.5%) , pets exposure in 8 (10%) and to mite was noticed in 5(6.25%) children. Marked improvement was observed in day time cough in group A with 10(25%) patients being free of cough with inhaler, while 20(50%) showed mild intermittent symptoms. 1(2.5%) showed mild persistent symptoms. In Group B 3(7.5%) patients were symptom free, 23(57.5%)with mild intermittent and 4(10%) with mild persistant symptoms while 6(15%) continued to have moderate persistent symptoms. P value was 0.01. Regarding day time breathlessness, P value was significant of 0.258. Similarly marked improvement was observed in night symptoms of breathlessness, cough and sleeplessness in both groups. P value was less than 0.05 in majority of the variables showing statistically significant improvement with inhaled beclomethasone than with oral montelukast. Conclusions: Inhaled beclomethasone is superior to oral montelukast in controlling chronic symptoms of childhood asthma. [ABSTRACT FROM AUTHOR]