We used noninvasive positive pressure ventilation (NPPV) with a helmet-type mask in two young children with acute severe bronchial asthma. The intervention was well-tolerated, because the helmet-type mask caused no pain or discomfort, as compared to the face mask. Tracheal intubation can be avoided by the start of the NPPV. Thus, the respiratory symptoms improved by the use of NPPV in children with acute severe asthma with respiratory muscle fatigue and failure of medical treatment.