Introduction: Acute bronchiolitis is a common cause of hospital admission in children. Nebulized therapy has been routinely administered even though it has not been shown to have significant benefit in many studies. Objectives: To evaluate the effectiveness of treatment using nebulized salbutamol and 3% hypertonic saline (HS) compared with nebulized salbutamol and 0.9% saline (NS) solution in acute bronchiolitis. Methods: Prospective, double-blind randomized controlled trial was conducted from Apr. 2014 till May 2016 in previously healthy children younger than 18 mo old, admitted to Hospital Universiti Sains Malaysia with mild to moderate acute viral bronchiolitis. Patients were randomized to receive either nebulized HS with salbutamol (intervention group), or nebulized NS with salbutamol (control group). Outcomes and measures: The primary outcome was to compare the mean difference in the clin. severity score between the two groups at baseline, 8, 24, 48 and 72 h post treatment. The secondary outcome was to compare the mean difference in the length of hospital stays among the two groups (days). Results: One hundred one (101) patients with acute bronchiolitis were included in this study (HS, n = 52; NS, n = 49). The mean age of the HS group was 7.1 mo and NS group was 8 mo. There was no difference in the clin. severity score between group (p =.250) and the duration of hospital stay in both groups (p =.146). Conclusions: We concluded that there were no differences in term length of hospital stay and the clin. severity score for both interventional and control group.