A prospective observational study was conducted at Mahatma Gandhi Memorial (MGM) hospital, Warangal over a period of 6 months. This study is conducted to evaluate clinical presentation of various respiratory conditions and to optimize oxygen, inhalational therapy and antibiotic treatment for optimal outcome. We conclude that many children were under 5 commonest age group, suffering from wheeze, respiratory distress and asthma. Nebulization of salbutamol was useful in HRAD and asthma rather than bronchiolitis and LRTI. IV hydrocortisone was beneficial in HRAD and less beneficial in bronchiolitis. Supplemental oxygen was most effective treatment in bronchiolitis condition. None of the children were receiving holding chambers or spacers. At least some percentage of the children in the present study may require spacers in long term use to decrease morbidity.