One objective of the Healthy People 2010 initiative calls for the establishment of a surveillance system to track asthma illness and management in at least 25 states. Our objective was to report patterns of asthma-related medical services and pharmacotherapy use among recipients of Texas Medicaid. Texas Medicaid medical services and prescription administrative claims data dated between January 1 and December 31, 2000, for recipients between 6 and 64 years of age enrolled in a fee-for-service plan were extracted. Rates of recipients with asthma, rates of asthma-related medical services use, and patterns of pharmacotherapy use were reported. There were 31,509 recipients identified with asthma at a rate of 22.8 per 1000. Children under 15 years of age, males, and blacks had the highest rates of asthma, as well as asthma-related emergency department (ED) visits and hospitalizations compared with other demographic groups. Hispanics accounted for the largest proportion of ethnic groups but had the lowest rate of asthma compared with whites and blacks. The rate of ED visits and hospitalizations among children was more than twice the rate among adults. Blacks had more than twice the rate of ED visits and nearly double the rate of hospitalizations for asthma compared with other ethnic groups. Roughly 56% of the recipients had a claim for an inhaled anti-inflammatory medication. However, it appeared that recipients were using short-acting beta-agonists more frequently than inhaled corticosteroids. Use of medical services and prescription medications for asthma varied greatly on the basis of recipient demographic factors.