Objective To explore the clinical effect of nebulization combined with budesonide and ipratropium bromide in the treatment of children with obstructive respiratory diseases. Methods Using random number table method, 150 children with respiratory obstruction diagnosed and treated in the Department of Pediatrics of Nanping People's Hospital from March 2021 to March 2023 were divided into twos groups, with 75 cases in each group. Both groups received conventional symptomatic treatment. On this basis, the control group was given budesonide aerosol inhalation treatment, and the observation group was given budesonide aerosol inhalation treatment combined with compound ipratropium bromide. The respiratory function, symptoms and signs scores of the two groups before and after treatment were compared, and the total clinical effective rate and adverse reactions of the two groups were analyzed. Results After treatment, RR and PaCO₂ levels in observation group were lower than those in control group, and PaO₂ levels were higher than those in control group (P<0.05). Symptoms and signs scores of the observation group were lower than those of the control group after treatment (P<0.05). The total clinical effective rate of the observation group was higher than that of the control group (P<0.05). The incidence rate of adverse reactions of the observation group was lower than that of the control group (P<0.05). Conclusions The application of budesonide combined with compound ipratropium bromide atomized inhalation in children with respiratory obstructive diseases can obtain significant clinical therapeutic effect, which can not only promote the improvement of symptoms and signs, but also restore normal respiratory function, without additional adverse reactions, and has high safety.