Objectives:The Salford Asthma Register was launched at the beginning of 1995 to record the details of all asthma patients in Salford, Greater Manchester, UK. Design:An IT system was developed for the registration, annual review, audit and feedback of data to general practices on the status of their registered asthma patients. Setting and subjects:On joining the Salford Asthma Register, each practice submits a list of their current asthma patients to a central database maintained at Hope Hospital. Patients with chronic obstructive pulmonary disease (COPD) and children below one year of age are excluded from the register. Main outcome measures:An annual review sheet for every registered patient is generated by the database and returned to the practice. Asthma patients numbering 10,841 have been registered from 41 general practices covering 70% of the population of Salford. Of these, 2244 (20.7%) have had an annual review and 1545 (14.3%) have been recorded as resolved. All participating practices have received annual asthma reports comparing their asthma management with the district average. Most asthma measures (peak expiratory flow, daytime and nighttime symptoms) progressively deteriorated from the BTS Step 1 to Step 5. We were able to identify possible under-treatment in some patients in Step 1 and provide feedback to the practices concerned. Conclusions: In this observational study, we have shown that it is possible to establish a broad-based asthma database in an NHS district, which provides valuable feedback to the primary care team. We feel that this database and asthma monitoring methodology could be utilised elsewhere in the country. This could be an important tool in clinical governance.