Published asthma death rates have risen during recent years. This may be due to a number of possible factors and it is important to assess whether or not the increase is genuine. Evidence from the BTA confidential enquiry into asthma deaths together with the results of bridge coding by the Office of Population Censuses and Surveys suggest that published death rates in the 15-44 year age group are reasonably accurate and comparisons before and after recent changes in the International Classification of Diseases are valid. The death rate in females in this age group has almost halved since the pre-epidemic levels of the 1960s, whereas the rate for males is little changed. This should alert all those involved in the management of severe acute asthma to the seriousness of the problem that remains.