Abstract Within the total therapeutic spectrum for asthma, some patients (currently 46 percent of the resident population of patients at CARIH) require prolonged maintenance therapy with corticosteroids. After a daily minimal effective dose of a selected “short acting” cortisone analogue has been established, patients can generally control their asthma with prednisone or methylprednisolone taken every 48 hours in the early morning at doses slightly more than twice the amount previously taken daily. Such an alternate day regimen has been found to be associated with fewer clinical side effects and also with minimal adrenal cortical suppression. Pulmonary function of the patients on alternate-day treatment could be maintained at a satisfactory level throughout the 48 hour cycle, showing the physiologic circadian variations observed in healthy individuals. Ordinary stress, such as an acute febrile illness, was tolerated by patients on alternate-day therapy uneventfully. Severe stress—not noted among the patients studied—may still require additional corticosteroid therapy immediately. Acute exacerbations of asthma necessitated interruption of alternate-day therapy and the administration of additional steroids initially and repeatedly at intervals of 4 to 6 hours, in conjunction with all other appropriate therapy, for at least 24 to 48 hours or a few days. Patients adequately controlled on an alternate-day schedule should be and are being observed continuously in order to assess the ultimate benefits—or untoward effects—of alternate-day steroid therapy.