Diagnosis of asthma is clinical, however due to varied presentations in childhood both under and over diagnosis are possible. A good number of cases may not present with wheeze but may have a cough variant asthma. Episodic symptoms of airflow obstruction and reversibility are two very important features of asthma. Many congenital (Cystic fibrosis) and acquired conditions (foreign body) may cause wheezing in childhood and should be ruled out clinically or by specific investigations. Spirometry and peak expiratory flow rates help in objective assessment and are good tools for monitoring chronic patients. Total IgE has no role in diagnosis. There is now emphasis on co-management of asthma and patient/parents should be trained to keep symptoms records and wherever possible peak flow records. They should also be taught proper interpretation of readings for stepping up therapy in case of worsening.