Background: Prevention Program published Focused Updates to the Asthma Management Guideline (Guideline Update) which includes Single Maintenance and Reliever Therapy (SMART) as daily and emergency management for some children with asthma. It is not known if school nurses have knowledge or experience with the Guideline Update, specifically SMART, which could affect the care students receive. The purpose of this study is to understand school nurse knowledge of the Guideline Update. Children with asthma face multiple challenges that encompass learning how to cope with. Bronchial asthma (BA) is a public health problem in all countries irrespective of their level of development, being generally under-diagnosed and undertreated, and most asthma-related death commonly occurs in low-income and lower-middle income countries .As for Saudi Arabia, it is estimated that more than 2 million Saudis have asthma, and the percentages range from 8% to 25% in Saudi children. In 2004, the highest prevalence of asthma was reported by physicians in Saudi Arabia (25%). Bronchial asthma is a serious disease since it is very common disease in Saudi Arabia, and it doesn’t only affect the individual physiologically, however it also affects the individual’s quality of life, leading to missing days from school or work, emergency hospital visits, hospitalization, and caregivers and parents’ time and effort. Consecutively, it affects the whole community. Aim of the study: To assessment the School Nurse Awareness of the regarding childhood Asthma Management Guidelines 2022 . Method: A cross-sectional study was conducted attending the primary health care centers in Makkah , Saudi Arabia. An asthma knowledge questionnaire was used to measure the knowledge. during the April to June, 2019, participants were (800). Results: Regarding awareness of the participant toward asthma study results show the majority of participant had average information were(59.0%) while weak awareness were(22.0%) the data ranged from(6-28) by mean ±SD(16.577±5.87). Conclusion: School nurses lack knowledge of the Guideline Update but are interested in education. The bronchial asthma knowledge in the Saudi Arabian population is insufficient, and efforts should be carried out to spread asthma knowledge to the people. Bronchial asthma management should include patients, parents, and public awareness regarding the disease, its symptoms, medications