In the past decade, there have been great advances in the approach to and management of pediatric asthma. Recent progress includes improved definitions, established guidelines, and novel therapeutic modalities. There is growing recognition that asthma is a heterogeneous entity and as such, individualized therapy is now standard when creating intervention plans. Asthma severity is classically categorized based on the concepts of impairment and risk. As more specific data is gathered on asthma subgroups, molecular pathways and cluster analysis, there has been a movement for categorizing patients into asthma phenotypes, which could serve to tailor therapies and optimize clinical response. This chapter will review the pathophysiologic processes involved in asthma; expose the latest definitions of asthma and management guidelines; discuss the implications of the “phenotypic” approach in pediatric asthma and present an overview of pertinent recent therapeutic advances.