Objective: To investigate the correlations between serum microRNA-146 a(miR-146 a) level and TCM syndrome types of children with bronchial asthma(asthma). Methods: From March 2017 to March 2019, 130 children with asthma during the attack period from the Department of Respiratory Pediatrics of our hospital were selected in the asthma group. 130 healthy children were selected as the control group. The expression of miR-146 a in the two groups of children were detected. The expression of miR-146 a in children with different TCM syndromes, and the score of asthma control test(ACT) were observed, and the correlation between them were analyzed. Results: The expression of serum miR-146 a and the level of interleukin 6(IL-6), total IgE(IgE), eosinophil in asthma group was higher than that in control group(P<0.05). The expression of serum miR-146 a and the level of IL-6, total IgE, eosinophil in children with cold asthma, external cold and internal heat types was higher than that in children with heat asthma type(P<0.05), and cold asthma type was higher than that in external cold and internal heat type(P<0.05). The ACT score of children with cold asthma, external cold and internal heat types were lower than those of heat asthma(P<0.05), while ACT scores of cold asthma were lower than that of external cold and internal heat type(P<0.05). The expression of miR-146 a was pos. correlated with ACT scores in children with cold asthma, external cold and internal heat, heat asthma types(P<0.05). Conclusions: The expression of serum miR-146 a in children with asthma is high, and miR-146 a is related to the TCM syndrome type and ACT score of asthma.