Worldwide, bronchiolitis is the most common severe acute lower respiratory tract infection. The usual criteria for hospitalization of a child with bronchiolitis are the need for oxygen or fluid management. Some infants have very high hospitalization rates of bronchiolitis (352 per 1,000) and the majority are retrieved from remote communities. In these settings, there are often no resident medical practitioners and nurses are the acute care providers. Availability of a scoring system for bronchiolitis that is valid when used by different providers, would be beneficial as acute assessment of the severity of bronchiolitis will contribute to good clinical management. Standardization of severity scoring is also important for clinical research purposes. A number of clinical scoring systems, some with modifications, have been used in the many research studies on bronchiolitis. Despite their widespread use, many of these scoring systems have limited validity when systematically evaluated and often were modified to suit individual research outcomes. These scoring systems have different levels of complexity (such as auscultation in “segmental lobes” and distinction of wheeze through parts of inspiratory and expiratory phases), clinical parameters (e.g. the widely used Lowell score does not take into account SpO2 or cyanosis) and varying degrees of validation (many were not validated), thus making it difficult to evaluate across clinical research studies. Not surprisingly, the Scottish Intercollegiate Guidelines Network (SIGN) bronchiolitis guideline stated “No good quality evidence on the use of formal clinical scoring systems in infants with acute bronchiolitis was identified.”