Vital statistics indicate increasing mortality from asthma since 1978 in the United States, England and Wales, Australia, and New Zealand. In Oregon and Washington, combined asthma mortality increased by 87% between 1977 and 1983. We reviewed the records of all patients (N = 41) (1) who died in hospitals or nursing homes in Oregon in 1982 and (2) whose death certificates listed asthma as the cause. Patients were 34 to 90 years old and half had been smokers. We found that most young patients who died clearly had asthma and died suddenly during severe attacks. Patients aged 55 and over frequently had bronchitis, emphysema, or chronic obstructive pulmonary disease rather than uncomplicated asthma, and were treated less aggressively than young patients. Their cause of death was often due to multisystem disease rather than reversible airflow obstruction. Reported statistics probably overestimate the true asthma mortality rate in the older population in Oregon.