Inhaled steroid therapy is being emphasized in the treatment of asthma but requires patient adherence to regular dosing regimens and skilled inhalation techniques for treatment to be effective. If used correctly, high-dose inhaled corticosteroids may eradicate specific types of inflammatory cells from the airway, whereas use of systemic corticosteroids in chronic asthma may not significantly reduce airway inflammation or clinical symptoms. We report a case in which reduction in inflammatory cells in the airway was confirmed by bronchoalveolar lavage after individual patient education, training in self-monitoring, and treatment with inhaled corticosteroids. Clinical symptoms were reduced after conversion of this patient from systemic to inhaled corticosteroids.