IntroductionBronchial asthma (BA) is a heterogeneous disease characterized by chronic airway inflammation. This study investigated the serum miR‐27a‐3p/activating transcription factor 3 (ATF3) expression in children with BA and their correlations with airway inflammation.MethodsChildren with BA (N = 120) and healthy children (N = 108) were enrolled. Serum levels of interleukin (IL)‐17, IL‐6, tumor necrosis factor (TNF)‐α, immunoglobulin E (IgE), miR‐27a‐3p, ATF3, and the number of eosinophils (EOS) were measured using enzyme‐linked immunosorbent assay (ELISA), reverse transcription quantitative polymerase chain reaction (RT‐qPCR), and an automatic hematology analyzer. The correlations between miR‐27a‐3p and ATF3 and between miR‐27a‐3p/ATF3 and inflammation‐related factors were analyzed by the Pearson method. The diagnostic values of miR‐27a‐3p and ATF3 in BA were evaluated using receiver operating characteristic (ROC) curves. The influencing factors of BA were assessed using multivariate logistic regression. Finally, the targeting relation between miR‐27a‐3p and ATF3 was predicted and analyzed by TargetScan and Starbase databases, and dual‐luciferase assay.ResultsThere were significant differences in forced expiratory volume in 1 s (FEV1)% predicted and FEV1/forced vital capacity (FVC)%, serum levels of IgE, IL‐17, IL‐6, and TNF‐α, and EOS numbers between healthy children and BA children. Serum miR‐27a‐3p was negatively correlated with ATF3 and positively correlated with inflammation‐related factors in BA children. Serum ATF3 mRNA levels were negatively correlated with inflammatory factors in BA children. miR‐27a‐3p and ATF3 had good diagnostic values in BA children. FEV% predicted, IL‐6, TNF‐α, miR‐27a‐3p, and ATF3 were independent risk factors for BA. miR‐27a‐3p targeted ATF3.ConclusionSerum miR‐27a‐3p was highly expressed, whereas ATF3 was poorly expressed in BA children, and they were significantly correlated with airway inflammation, had good diagnostic values in BA children, and were independent risk factors for asthma.