Children admitted to the ward for status asthmaticus may not receive the first albuterol treatment on schedule. We sought to determine if a difference in timing between scheduled and actual first dose of albuterol is associated with care escalation to the pediatric intensive care unit (PICU). We conducted a single-center case-control study of children 2-18 years admitted from the emergency department (ED) to the ward for status asthmaticus. Cases required transfer to the PICU within 24 hours of admission. Groups were compared using Fisher’s exact or Mann-Whitney U tests. Firth multivariable logistic regression estimated the association between dose timing and odds of transfer to the PICU. Groups did not differ by demographics, comorbidities, or asthma severity risk factors. The median (IQR) time difference between scheduled and administered first dose of albuterol was 0 (-14 to 63) minutes for cases and 16 (-6 to 42) minutes for controls ( p=.4). Fifty percent of cases received delayed treatment compared to 63% of controls ( p=.28). The adjusted analyses demonstrated that as the time difference between scheduled and administered albuterol increased by 1 minute, odds of care escalation to the PICU remained the same (OR=1.0, 95% CI: 0.9 to 1.0; p=.2). Receiving first albuterol treatment on the ward at a time different than scheduled was not associated with increased odds of transfer to PICU. Delayed albuterol administration did not vary with PICU transfer. Delays in treatment, when taken in the context of evidence-based asthma pathways, did not significantly impact hospital course or quality of care.