Asthma guidelines should lead to improved, more rational asthma medication prescribing. The aims of this study were to assess the trend of paediatric asthma drug prescribing in the UK and to assess the potential impact of the publication of the British Thoracic Society (BTS) asthma guideline. The estimated community paediatric prescribing figures for asthma medications in the UK were studied using data from the NHS Information Centre for Health and Social Care between the years 2000-2006. The number of prescriptions for bronchodilator syrups has decreased by 60% from 2000 to 2006. However, this still represents 121,000 prescriptions for bronchodilator syrups in 2006 despite minimal recommendations for their use. The percentage of steroid inhalers prescribed as combination inhalers of a steroid and a long acting beta agonist has increased from 2.7% in 2000 to 25.3% in 2006. Steroid alone inhalers should be the mainstay for the vast majority of asthmatics who require controller medications. This trend is not consistent with the guideline recommendations that the introduction of combination inhalers should only be in those asthmatics not controlled on adequate doses of inhaled steroids. Further education of health professionals is required.