A population aged 65 and over has been increasing in the developed countries. The prevalence of asthma in elderly patients is estimated between 6.5 and 17%. Asthma is an important cause of morbidity and mortality in the elderly. Moreover, death due to asthma occurs mostly in elderly patients. Only a few studies have reported the characteristics of asthma in the elderly patients. Two distinct clinical presentations of asthma have been described in the elderly. There are differences both in the pathophysiology and the clinical manifestation of asthma between elderly patients with a long-standing disease and those with late-onset disease. Additionally, aging of the respiratory system influences the asthma presentation. Asthma has been presented for many years may lead to persistent obstructive ventilatory defect and can mimic chronic obstructive pulmonary disease. Irreversible obstruction is commonly observed in elderly patients with asthma. The differential diagnosis of asthma is difficult in older adults and asthma is underrecognized and undertreated in the older population. Undertreatment is common in elderly asthmatics which largely is related to diagnostic issues.