Hospitalization rates for asthma are higher in the Northeast United States than in other regions, despite similar regional prevalence rates. Whether these higher rates reflect differences in asthma presentation or severity or else general differences in hospitalizations is unclear. We examined regional differences in asthma hospitalizations for the United States from 1988 through 1996 using data from the National Hospital Discharge Survey. We classified asthma hospitalizations into those in which asthma was either the primary diagnosis or any listed diagnosis. From 1988 through 1996, the rate of hospitalizations for asthma as the primary diagnosis, per 10,000 population, increased in the Northeast, but declined in other regions. By 1996, these rates were 24.5 in the Northeast, 18.4 in the Midwest, 15.8 in the South, and 14.2 in the West. The Northeast also had the highest absolute rate and the highest rate of increase for asthma as any listed diagnosis during the study period. These higher rates of asthma hospitalizations in the Northeast occurred despite a 9.3% decline in the age-adjusted rate for all hospitalizations in the region. These results indicate a greater rate of hospitalization for asthma in the Northeast than in other regions, suggesting that asthma there may be more severe.