Asthma is one of the most common chronic diseases worldwide with an estimated 300 million affected individuals. Grading of asthma based on clinical presentation is going from acute severe asthma over life threatening asthma to near fatal asthma There are only a few diagnostic methods that we can use for patients with severe form of asthma because. This is because of severity of disease which disables them to complete usually used diagnostic tests. Treatment of patients with severe form of asthma is difficult. Today we have precisely defined criteria for hospital admission, so we will not waste time to decide whether patient is of general ward, high dependence unit or intensive care unit. Thanks to latest GINA recommendations we updated about treatment procedures for each patient based on severity of disease. It is extremely important to choose adequate therapy as soon as possible, because we do not have big margin for an error. Therapy should be based on latest GINA recommendation.