Cockroach infestations have been indicated as a major contributor to asthma throughout the world. Several studies have shown that large numbers of asthmatic patients are sensitized to cockroach allergens. Eliminating this pest from homes, schools, and public buildings involves a long-term commitment to a rational extermination process. This article covers the characteristics of the major cockroach species that invade homes, assesses the role of environmental exposure to cockroaches in asthma, and provides an intervention program for their extermination.