Airway inflammation and immune activation plays a critical role in the pathogenesis of asthma. Corticosteroids are the most potent anti-inflammatory therapy used in this chronic disease and Inhaled corticosteroids (ICS) being the first line therapy for long term management of asthma along with beta 2 agonists. Certain asthma patients however fail to respond to the combined systemic and inhaled corticosteroids treatment despite very high doses over extended treatment period. Recent studies indicated that steroid resistant asthma is associated with a failure of corticosteroid to inhibit their invitro T-cell proliferation and cytokine secretion. More importantly T-cells from peripheral blood of steroid resistant asthmatics are not steroid sensitive. Using a strict clinical definition of SRA leads to better investigation and treatment of patients showing resistance to corticosteroids. Allowing the conventional combination therapies (i.e ICS with beta 2 agonists) and adding drugs directed against inflammatory pathways or mediators are likely to prove the most effective new therapeutic regimen in the future for steroid resistant asthma like to name few novel anti-inflammatory drugs, immunomodulatory drugs and vitamin D to be used with confidence.