Background: Nebulized hypertonic saline (3% NaCl) solution may reduce these pathological changes and decrease airway obstruction and there by improve bronchiolitis. Objective: To assess the Physical Findings and Clinical Improvement of Nebulized Hypertonic Saline Solution of Hospital Stay. Methodology: Randomized, double blind controlled trial. The study was conducted in the department of pediatrics, MAG Osmani Medical College Hospital, Sylhet, Bangladesh from January 2009 to December 2009. Ninety hospitalized children (mean  SD age, 11.112.3 months) with viral bronchiolitis received inhalation of (group-I), and 91 children with viral bronchiolitis received inhalation of salbutamol solution with normal saline (group-II). Results: There was improvement in both groups after inhalation of either hypertonic saline solution (Group-I) or salbutamol solution with normal saline (Group-II) on the first, second and third days after hospital admission. Head nodding and nasal flaring were reduced all the patient of both groups after second day of hospitalization and variables were not statistically significant (P> 0.05). Duration of hospitalization was 3.611.51 days in group-I and 3.161.22 days in group-II and it was not statistically significant (p>0.05). Conclusion: The study concluded that 3% hypertonic saline nebulization significantly reduced clinical severity, length of hospital stay and duration of oxygen therapy in case of acute bronchiolitis in comparison to Group I and II. Both the modalities of treatment were found to have no adverse effect. Since hypertonic saline solution is cost effective than salbutamol solution and no significant adverse events observed, it can be used in children with acute bronchiolitis.