Background: Despite considerable advances in our knowledge of the pathophysiology of inhalation injury, there are few specific therapeutic options, and patient care is mainly supportive. Platelets release growth factors and other immune system components to start healing process. By using nebulized Platelet Rich Plasma (PRP), platelets may reduce inflammation and stimulates bronchial tree healing. However, there are no clear data supporting or refuting the use of inhaled PRP in inhalation injury. Objective: To evaluate the role of nebulized autologous Platelet Rich Plasma (PRP) in management of Smoke Inhalation Injury (SII) as early adjuvant therapeutic and prognostic modality.Methods: This is prospective study that included 40 patients with burns 25-50% TBSA and have inhalation lung injury. They were divided into 2 groups; 20 patients received aerosolized particles of nebulized PRP beside regular regimen. The other control group included 20 patients and received regular treatment regimen only.Results: There was a statistical significant difference (p<0.01) of biologic changes in upper airway with smoke injury in study group patients compared to control group patients who received regular protocol measured at the same follow-up time interval, relatively same TBSA and initial bronchoscopy scoring. The mean extubation time was 7±1 days in study group compared to 14±1 days in control group. Study group less showed shorter hospital stay and less mortality rate. Conclusion:The application of aerosolize the PRP solution in the nebulizer with regular treatment protocol of inhalation burn patients could be a beneficial therapeutic tool for regenerating of post burn damaged tracheo-broncho-pulmonary tree. Further studies on larger patient population with clinical and pathological evidences are warranted.