Background: Acute bronchiolitis is one of the most common reasons for hospital admission in infancy. Treatment depends on humidified oxygen (O2), properly administered fluids, and adequate nutrition. The aim of this work is to assess the value of CPAP in the management of infants with severe bronchiolitis in the PICU. Methods: 32 infants younger than one-year-old with severe bronchiolitis were recruited. Cases were divided randomly into two groups; Group A, used the standard treatment, and Group B, used nasal CPAP. Primary assessment was done for infants by recording baseline vital signs, grade of respiratory distress, and capillary blood gases. Re-evaluation was done after 12 hours and 24 hours. Evaluation of the outcome was done for the length of PICU stay, hospital stay, the need for mechanical ventilation and any complications. Results: In the CPAP group, a significant improvement in respiratory distress was found after 24 hours. There was a significant improvement in O2 saturation after 24 hours (P<0.01). There was a significant increase in PH (P<0.01) with a significant decrease in CO2 after 24 hours (P<0.01). Improved outcomes were noticed in the CPAP group with a decrease in the duration of PICU and hospital stays (P< 0.05). Conclusion: Nasal CPAP rapidly decreased the respiratory muscle work and improved the blood gases, which resulted in a decrease in the PICU, and hospital stay, suggesting the importance of rapid initiation of CPAP in the more severe forms of the disease.