Status asthmaticus, the most severe form of asthma exacerbation, is a life-threatening condition. The mortality rate in status asthmaticus ranges from 3.5% to 8.3%. Therapeutic approach in acute severe asthma is based on oxygen supply, high doses of nebulised beta2-agonists and systemic corticosteroids administered intravenously or orally. Second line therapy is comprised of methyloxantines, nebulised cholinolitics and management of electrolytes and water balance. Status asthmaticus resulting in acute respiratory failure will often require invasive or non-invasive mechanical ventilation. Mortality in patients with asthma who require mechanical ventilation might exceed 20%. International guidelines for management of status asthmaticus have been published recently, but those recommendations often remain unknown. Thus there is an urgent need for elaboration of national standards on managing acute severe asthma and putting it into clinical practice. Status asthmaticus, especially a severe one, should be treated in a respiratory intermediate intensive care unit.