Background: Several studies have explored the predictive value of impulse oscillometry (IOS) for asthma exacerbations in childhood, but its specific parameters are still unclear. Therefore, we designed this meta-analysis to determine the related indicators of acute asthma attacks. Methods: A comprehensive literature search was performed in July 2020 based on Pubmed, Embase, and Web of science database. Weighted mean differences (WMD) were calculated using Fixed-or random-effects models. Results: A total of 615 patients from 6 trials were included in this analysis. IOS may be a useful tool to predict asthma exacerbations. And the results showed that R5 (WMD = − 1.21, 95%CI: −1.55 to −0.87, P＜0.001), Fres (WMD = − 1.34, 95%CI: −2.03 to −0.65,P=0.018) and AX (WMD = − 7.35, 95%CI: −9.94 to −4.76,P＜0.001) had significant correlation with asthma exacerbations. In addition, X5 may also predict the acute attack of asthma (WMD =0.81, 95%CI: 0.56 to 1.01, P＜0.001). Conclusion: R5, AX, Fres, and X5 may be able to identify the risk of an acute attack of asthma. Besides, our research further demonstrated that peripheral airway injury may play an important role in the acute attack of asthma.