Abstract: OBJECTIVE To analyze the relationship between fractional exhaled nitric oxide (FeNO) levels and airway inflammation and airway remodeling in children with bronchial asthma, and its impact on asthma control status. METHODSA total of 180 children with bronchial asthma admitted to Jiaxing Maternity and Child Health Care Hospital from Jan. 2023 to Dec. 2025 were enrolled and divided into a low-level group (<25 ppb, n=48), a medium-level group (25-50 ppb, n=86) and a high-level group (>50 ppb, n=46) according to FeNO levels. We compared the clinical data among the groups and analyzed the impact of FeNO levels and airway inflammatory factors on asthma control status. RESULTSInterleukin (IL)-4, IL-17A and transforming growth factor-β1 (TGF-β1) were positively correlated with FeNO levels (P<0.05), while interferon-γ (IFN-γ) was negatively correlated with FeNO levels (P<0.05). Significant interactive effects of IL-4, IFN-γ, and FeNO levels on wall thickness to outer diameter (T/D) were found (P<0.05). Similarly, significant interactive effects of IL-4, IL-17A, IFN-γ, and FeNO levels on wall area tootal airway cross sectional area (WA) were found (P<0.05). The area under the curve (AUC) for diagnosing uncontrolled asthma through FeNO levels was 0.875 (95% CI: 0.829-0.911). A nonlinear dose-response relationship between FeNO levels and the risk of uncontrolled asthma (nonlinear test P=0.012) was observed, showing a positive correlation. CONCLUSIONS FeNO levels and CD₄⁺ T cell-mediated airway inflammation in children with bronchial asthma have interactive effects on airway remodeling. Together, these two factors regulate the process of airway remodeling and can be used as effective biomarkers to evaluate the risk of uncontrolled asthma.