Asthma is a chronic illness and a national Australian priority. Gaps in service delivery to Aboriginal peoples and Torres Strait Islanders are identified in national policies. Asthma has consistently remained the second-most common self-reported long-term illness in Indigenous Australians with a prevalence of 15%. Hospital separation rates and hospitalisation days for asthma are higher for Indigenous Australians in every age group. Reasons for this are unclear although there is some evidence that the Aboriginal and Torres Strait Islander population with asthma have suboptimal use of medications and poorer access to preventive health care. Primary prevention of asthma includes avoidance of tobacco smoke exposure (in-utero and ex-utero) and obesity, and poverty alleviation. Secondary prevention strategies for the early detection and treatment of asthma as an isolated respiratory illness and as a co-existent morbidity can prevent hospitalisations as well as short- and long-term morbidity. The basic management of asthma in Indigenous Australians is identical to that in non-Indigenous Australians and includes optimal treatment by utilisation of appropriate asthma medications and devices, education and asthma action plans, as well as avoidance of pulmonary intoxicants such as tobacco smoke. However, the delivery of health care and asthma programs requires modification. Based on international data, specifically designed asthma programs are necessary to be effective for Aboriginal and Torres Straits Islander peoples with asthma.