Asthma is a chronic airway disease that typically presents with episodes of severe respiratory distress known as exacerbations. Asthma exacerbations result in 1.8 million hospitalizations per year, with an estimated mortality rate of 13.3 deaths per million per year in US adults.1 This article summarizes evidence regarding management for acute asthma including (1) inhaled corticosteroids (ICSs), (2) azithromycin and magnesium, (3) nebulized bronchodilators vs metered-dose inhalers, and (4) innovative therapies undergoing investigation for treatment of adults with acute asthma exacerbations. Randomized clinical trials of acute asthma management published in major medical journals in the past 7 years were reviewed.