The European Respiratory Society and the American Thoracic Society recently published the international ERS/ATS guidelines on definition, evaluation and treatment of severe asthma. It is aim of the guideline to establish standardized diagnostic criteria and to develop evidence based diagnostic and therapeutic strategies. In the diagnostic approach verifying the diagnosis of asthma and identifying comorbidities and contributing factors are very important. In the therapeutic guidance of asthma patients steroid insensitivity and overdosage of betamimetic inhaler therapy are typical challenges. Novel therapeutic strategies open the perspective to personalized therapy in asthma.