New treatment modalities have emerged since the introduction of inhaled drugs for the treatment of childhood asthma. Theophylline preparations are practically no longer used for asthma exacerbations, as inhaled β2-agonists and ipratropium bromide are sufficient for bronchospasm relief. Many long-term studies have established the effectiveness and safety of inhaled steroids, which henceforth replaced sodium chromoglycate, a widely used prophylactic drug. Leukotriene receptor antagonists and long acting β2-agonists are appropriate add-on treatment for those children not responding to steroid monotherapy. Patient compliance, as well as inhalation technique should always be checked before stepping up to more intensive treatment. Pneumon 2004, 17(3):251-257.