Asthma is probably the commonest chronic disease in the United Kingdom, and its attendant morbidity extends outside the possible scope of the hospital sector. Innovations to improve the care of asthma must therefore come from general practice. The need for such care initiatives is demonstrated by the rising mortality and morbidity from this condition, and by the evidence of less than optimum treatment at both the primary and secondary care levels. This paper reviews this evidence, and considers possible solutions to the problems raised. Pragmatic guidelines are offered for the promotion of good asthma care, while the need for proper evaluative research is stressed.