Aspergillus (ASP) sensitization is frequent in severe asthma (SA). Aspergillus-associated disease, such as allergic bronchopulmonary aspergillosis (ABPA) and chronic pulmonary aspergillosis (CPA) can be associated with bronchiectasis (B). B is a comorbidity in patients with SA. We investigated the prevalence and the characteristics of Aspergillus-associated bronchiectasis in 73 consecutive immunocompetent patients with SA. Methods: All the patients underwent assessment of history, spirometry, FENO, circulating eosinophils (EOS), serum total IgE, IgE-ASP (increased if > 0.10 kUA/L), and IgG-ASP (increased if >40 U/ml), chest X-rays, paranasal sinus CT and chest HRCT. ABPA and CPA were diagnosed according to Agarwal and Denning (Clin Exp Allergy 2013) and ERS/ESCMID consensus (Eur Respir J 2016). Results: Bronchiectasis was found in 30 (41%) patients and was significantly associated with higher IgG-ASP (64+-75 vs 22+-35 U/ml,p=0.002), increased annual exacerbations (3.33+-1.7 vs 2.1+-1, p Among B patients, 9 were non-sensitized (30%), 4 had only IgE-ASP (13%, 3 with ABPA), 7 had only IgG-ASP (23%, 5 with CPA), and 10 had combined IgE-ASP and IgG-ASP (33%, 9 with ABPA and 7 with CPA). Conclusions: SA patients with bronchiectasis should be screened for ABPA and CPA using both IgE-ASP and IgG-ASP. Early recognition and treatment of Aspergillus-associated bronchiectasis in SA might decrease exacerbations and evolution toward irreversible airway remodeling