Asthma is a chronic inflammatory disorder characterised by airflow obstruction. The inflammatory process involves mast cells, antigen presenting cells, eosinophils, neutrophils, airway epithelial cells and TH2 lymphocytes. These cells produce a broad array of pro-inflammatory mediators and cytokines that lead to the pathophysiological changes seen in asthma. The improved understanding of this complex disease, the specific cells and the complex mediators has lead to newer insights into the efficacy of various novel and potential therapies. In this review, we discuss the pharmacological agents that interrupt the synthesis and action of leukotrienes, cytokine antagonism, monoclonal antibodies against IgEs, selective phosphodiesterase inhibitors, adenosine receptor ligands and immunomodulators to drive the inflammatory response towards a TH1 type and other possible specific targeted therapy for the management of asthma. Although most of these therapies are in the inchoate stages these may hold the future for use in asthma.