This review delineates the currently accepted, multifaceted approach to the care of an asthmatic patient. Therapy is based on our improved understanding of the pathophysiology of this complex disease, in which IgE and mediators derived from many cells contribute to airway inflammation. The latest trends in therapy involve the institution of anti-inflammatory medications relatively early in disease. With the recent availability of a novel class of therapies, the leukotriene antagonists, and other therapies based on antagonism of adhesion molecules, cytokines, chemokines, or IgE itself, the future may provide additional alternatives for the physician treating patients with asthma.