Asthma is a long-term non-communicable disease that affected more than 339 million people in 2016. 1 Even with the advancement in the methods of diagnosis and treatment, asthma prevalence is increasing in several world regions and continues to cause considerable mortality and morbidity. 2 Asthma symptoms first onset commonly occurs during the preschool years, 3 and it is considered as the most common and serious chronic disease among children. 4 Nevertheless, asthma diagnosis in children is challenging, 5 and there is no gold standard test to make the diagnosis. 6 However, spirometry test has been proven to be a clinically useful technique that can be used to evaluate lung function in different age groups including children. 7 Spirometric reference values differ based on several factors including age, sex, height, weight and ethnic origin. 8 On the basis of these factors, different equations had been developed to predict spirometric reference values that can be used to interpret spirometric results. However, several challenges arose when it came to interpreting the spirometric results of the children as wrong interpretation of spirometric results was not uncommon. 6 In the Middle East, the spirometric result interpretation is even more complicated as the commonly used reference equations (mostly pre-installed equations in the spirometric devices/software) were developed based on data