BACKGROUND: Approximately 10% to 50% of competitive athletes experience asthma symptoms with exercise, due to either chronic asthma or exercise-induced bronchospasm. Early recognition and management of asthma symptoms may improve athletic performance and quality of life for athletes with asthma or exercise-induced bronchospasm. Athletic trainers may have frequent opportunities to identify asthma symptoms and assist athletes with management. OBJECTIVE: To survey athletic trainers about their experience and comfort with evaluation and management of asthma symptoms in athletes and identify athletic trainer characteristics associated with higher comfort levels. DESIGN AND SETTING: A 2005 cross-sectional survey of National Athletic Trainers' Association and Illinois Athletic Trainers Association members. PARTICIPANTS: A total of 304 athletic trainers. DATA COLLECTION AND ANALYSIS: Respondents completed a Web-based survey reporting years of experience, competitive level of athletes supervised, satisfaction with asthma education, experience evaluating asthma symptoms, and comfort managing asthma. RESULTS: Response rate was 13.9% (304 of 2,175). At least 23% of respondents evaluated asthma symptoms five or more times the previous year. Respondents working exclusively with junior high and/or high school athletes evaluated asthma symptoms more frequently than those working exclusively with college and/or professional athletes. Fifty-eight percent of respondents were unsatisfied with their asthma education. Only 25.3% were "very" comfortable managing asthma. Respondents with higher comfort levels evaluated asthma symptoms more frequently (p < 0.01, r = 0.18) and were more likely to be satisfied with their asthma education (p < 0.001). Over 95% of respondents endorsed more asthma education in athletic training curricula. CONCLUSIONS: Results of this pilot study indicate that athletic trainers have opportunities to help athletes manage asthma symptoms that can compromise athletic performance or limit sports participation. However, few athletic trainers are very comfortable managing asthma, and most are unsatisfied with their asthma education. Further study is needed to determine the effect of enhanced asthma education on athletic trainers' comfort and skills with asthma evaluation and management.