OBJECTIVES: This study investigated the relationship between psychosocial and behavioral factors and the frequency of emergency department visits for childhood asthma. METHODS: Data obtained from a survey of parents of 445 children who were being treated for asthma in the emergency room of a large urban hospital were examined. RESULTS: Factors associated with high emergency department use included the child's being of younger age, a greater number of days with symptoms of asthma, a higher number of asthma medicines prescribed, a prior hospitalization for asthma, a lower level of parental confidence in the efficacy of medicines, and a failure to use a criterion for deciding to seek emergency care. CONCLUSIONS: Younger children with asthma and children with previous hospitalization for asthma are at high risk for using emergency care. Families who use the emergency department frequently need to be further educated in the inflammatory nature of the disease, in the efficacy of proper use of medicine, in the need for ongoing care, and in criteria to distinguish those symptoms that can be handled at home from those requiring emergency care.