Purpose: In an effort to understand and improve the care delivered to patients with asthma, Sunnybrook Health Science Centre [SHSC], a fully affiliated teaching hospital of the University of Toronto, undertook a study of all its contacts with these patients. Each year the hospital has about 17,000 discharges. The number of these in which asthma was the main reason for admission fell from 142 in 1993 to 52 in 1995. Furthermore, of the 40,000 patient encounters in the Emergency Department in 1995, less than 1% were for asthma. The majority of the contacts with the asthma patients were in the ambulatory setting. Methods: All adult (age>15) asthmatics who attended the Family Practice Unit (FPU) (40,000 visits per year) were identified and a random sample (n=180) received both the SF-36 Health Survey and Juniper's Asthma Quality of Life Scale (QoL). All charts were audited to provide information on comorbidity and utilization. One hundred and twenty-five questionnaires were returned (69.4%). Results: Less than 10% of these patients are smokers and only 5.2% are on theophylline products. Thirty-five % were on low dose inhaled steroids and 44% were on high dose. No patient was on regular beta agonist medication without steroid inhalers. Only 6% had visited an emergency department for asthma in the last two years and only 3.8% had been admitted for asthma over that period. However, only 14% had their own peak flow meter (PFM). In 72% of their encounters for asthma in the FPU no PFM readings were recorded. Conclusions: There was significant correlation between the scores for the SF-36 and the QoL results. As the need for steroid medication increased, these measures fell. Clinical Implications: There are significant areas for improvement in the care of asthma patients in the FPU.