Objective: To investigate the effect of recombinant human interferon α-2b (rhIFNα-2b) combined with budesonide aerosol inhalation in the treatment of children with respiratory syncytial virus (RSV) infectious pneumonia and its influence on wheezing symptoms and inflammatory response. Methods: Sixty children with RSV infectious pneumonia who were treated in the hospital from January 2023 to August 2025 were prospectively selected as study subjects, and were divided into combined group and single drug group by random number table method, with 30 cases in each group. The single drug group received routine symptomatic treatment and budesonide aerosol inhalation, and on the basis of the single drug group, the combined group was added with rhIFNα-2b aerosol inhalation. The disappearance durations of primary symptoms (cough duration, wheezing duration, lung rale duration, fever abatement time), serum inflammatory cytokines [C-reactive protein (CRP), procalcitonin (PCT)] and occurrence of adverse reactions were compared between the two groups. Results: The durations of cough, wheezing and lung rale and fever abatement time in combined group were shorter than those in single drug group (P<0.05). The levels of CRP and PCT in both groups were decreased after treatment (P<0.05), and the levels were lower in combined group (P<0.05). There was no significant difference in the total incidence rate of adverse reactions between the two groups (16.67% vs 13.33%) (P>0.05). Conclusion: rhIFNα-2b combined with budesonide aerosol inhalation in the treatment of RSV infectious pneumonia in children can effectively relieve cough, wheezing and fever symptoms, and reduce serum inflammatory cytokines, and it does not increase adverse reactions.