Background Common adverse reactions of terbutaline include skeletal muscle tremor, headache,tachycardia, palpitations, hypokalemia and so on.Bronchospasm caused by terbutaline is rarely reported. This article reports one case of severe bronchospasm caused by nebulized terbutaline sulfate inhalation therapy. Case presentation A 51-year-old female patient was admitted to hospital with acute bronchitis.The main complaints were cough, sputum and wheezing. She has no history of drug or food allergies. On the day of admission, terbutaline nebulization treatment immediately caused limb tremor and bronchospasm. After glucocorticoid, aminophylline, non-invasive respiratory support and other symptomatic treatments,the patient improved on the 4th day. Conclusion The mechanism of terbutaline leading to bronchospasm is still unclear. The tert-butylline on the chemical structure of terbutaline may bind to proteins to produce IgE-mediated bronchospasm, The excipient ededidine disodium and the osmotic pressure of the nebulized diluent may also lead to bronchospasm. During the clinical treatment, hypotonic nebulizing dilutions should be avoided, and close monitor should be taken in case ofpossible fatal bronchospasm.