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Bronchiolitis is a complex disease that exhibits tremendous heterogeneity with respect to cause, clinical presentation, outcome and susceptibility of afflicted patients. Although respiratory syncytial virus (RSV) is widely considered to be the most important cause of bronchiolitis in children, little is known about the mechanisms of susceptibility to severe infection.Over the last several years, there have been important advances in our understanding of RSV bronchiolitis, ranging from large-scale epidemiologic observations to novel in-vitro discoveries, including those related to environmental and host risk factors. In addition, new investigative techniques have been developed, which may enhance our understanding about the interaction between RSV and the pediatric airway.RSV remains the most frequently encountered cause of bronchiolitis and contributes to significant morbidity and mortality worldwide. The investigations highlighted in this review may serve as foundations for future mechanistic studies, the implementation of new preventive strategies and the discovery of novel treatments.