Salbutamol is the most widely prescribed bronchodilator belonging to a class of drugs known as beta-2 adrenoceptor agonists, more commonly known as short-acting beta agonists (SABA). Their role is to relax airway smooth muscle (ASM), thereby reducing symptoms of wheeze, shortness of breath or cough in airways diseases such as asthma and chronic obstructive pulmonary disease (COPD). Salbutamol is generally regarded as a safe medication when used correctly. This article looks at the history of this class of medications, how they work at a cellular level, and the associated risks if they are overused or incorrectly used. It includes a discussion on the most commonly used SABA-containing device — the pressurised metered dose inhaler (pMDI). An understanding of the clinical and potential cellular effects of overuse will be discussed in the context of associated risks, as well as discussion on the drive to reduce greenhouse gases to care for the planet, and how this can be achieved while providing best care for patients