Background Breath holding spell is a type of syncope in which loss of consciousness may happen due to injury, fear, anger or frustration. No treatment for this illness has been offered yet. In this study, we evaluated the effect of Piracetam in controlling breath-holding spells (BHS) and its effect on controlling the symptoms of the disease. Methods The study was a double blind randomized clinical trial. Sixty one volunteer children with BHS from Bu- Ali hospital of Ardabil were recruited with Inclusion criteria: 1)Parental consent for participation in the plan 2) Normal EEG 3) absent of systematic disease 4) Normal growth and Development 5) History of breath- Holding spell and physical and neurological examination by pediatric neurologist. 6) No Electrolyte Abnormality (Hypoglycemia and Hypocalcaemia ) Exclusion criteria: 1) Children with history of convulsion 2) Children that received Anticonvulsant drugs. 3) Delayed neurotic development 4) all Children with heart diseases 5) all children with anemia 6) Side effects of priacetam including true dizziness, convulsion, extra pyramidal sings, lethargy, headache, and sleepiness. Subjects were randomly allocated into two groups. The first group received Piracetam suspension (40 mg/kg twice a day), and the second group received placebo. Over 6 months, the patients were evaluated every 2 months .