In the treatment of bronchial asthma and chronic obstructive pulmonary disease, it is important to use inhalation therapy adequately. A 60’s woman was admitted to our hospital due to exertional dyspnea. She was diagnosed as having exacerbation of asthma. Although she was treated with intravenous, oral, and inhalation administration simultaneously after admissi on, her symptom did not improve enough, and her pulmonary function was still low. Application of the inhalation check device supplied by the medicine manufacture company grant demonstrated that she failed to inhale effectively . Therefore the inhaled glucocorticosteroid was changed, and it was confirmed that she was able to inhale successfully. Her successful inhalation resulted in the improvement of her respiratory symptom and pulmonary function. It is suggested that the manipulation is very important factor on inhalation therapy, and it is necessary to strive to improve the adherence for the treatment of bronchial asthma and chronic obstructive pulmonary disease.