Asthma disproportionately affects minority individuals living in poor urban areas, particularly children and adolescents aged 5-17 years. A variety of factors are likely to account for asthma disparities in inner-city populations. Housing characteristics increase the risk of exposure to potential asthma triggers. Environmental risk factors have been studied extensively and cockroach allergen has emerged as an important determinant of asthma morbidity. Neighborhood factors also appear to contribute to the problem of inner-city asthma. Various novel treatment intervention strategies have demonstrated encouraging results. This article reviews environmental factors and recently published strategies to reduce morbidity in this vulnerable population.