71 Patients who were using inhalers in an inner city Dublin teaching practice were assessed by the author over a four month period to see if they were using their inhalers properly. 18 (25%) had perfect technique, 26 (37%) had adequate technique and 27 (38%) had poor technique. The patients most likely to have poor technique were those using a Metered Dose Inhaler (M.D.I.), patients using inhalers for less than one year and patients with a diagnosis of C.O.A.D. as opposed to Asthma. Of the 53 patients who had less than perfect technique 37 showed an initial improvement with training. This Author suggests that all patients should be fully evaluated before starting on inhalers and the most appropriate delivery system selected for them. They should be carefully instructed on its correct use and arrangements made for regular follow up to ensure good inhaler technique. This should lead to a greater clinical response and improved patient compliance.