The aim of the study was to investigate the role of alexithymia in bronchial asthma (BA) patients with low respiratory functioning hypothesizing that it could be used to differentiate a group of patients with clinically significant anxiety and depressive symptoms. We also aimed to investigate whether alexithymia was associated with reduced cognitive insight. Patients (n=153) were administered the State- Trait Anxiety Inventory-State subscale, the Beck Depression Inventory, the Toronto Alexithymia Scale, and the Beck Cognitive Insight Scale (BCIS). Alexithymia could help differentiate a group of patients with low respiratory functioning. Twenty-two percent of patients included in this subsample had airway obstruction, and 51% reported severe alexithymia. Patients with severe airway obstruction and high alexithymia (compared to other patients) also reported higher self-reflectiveness, and more depressive symptoms. Clinicians have to be aware of the presence of a subgroup of asthma patients with low respiratory functioning who report severe alexithymia. These patients often report moderate to severe depression and frequent doubts about one's own beliefs.