The clinical course of asthma in four patients younger than 25 years was considered. Three died unexpectedly of their disease, and the fourth was successfully resuscitated after cardiopulmonary arrest. None of these patients met the criteria for status asthmaticus in the period preceding their death. The time course of the illness from apparent wellness to death was documented as seconds to minutes. No obvious cause of the severe disease was found at postmortem in two patients or by clinical analysis in all four. Patients with bronchial asthma may die with this disease unexpectedly, rapidly and with no obvious cause for the severity of this process.