Exhaled carbon monoxide (eCO) is a potential non-invasive marker of airway inflammation. We have investigated the cross-sectional and longitudinal relationship between eCO and lung function and bronchial reactivity in 69 adults with atopic asthma, in the course of participation in a 6-week randomised placebo-controlled trial of vitamin E supplementation. At baseline, there was no cross-sectional association between absolute eCO levels and either forced expiratory volume (FEV(1)), forced vital capacity (FVC) or bronchial reactivity. However, in the longitudinal analysis within the placebo group, a rise in mean eCO was significantly associated with improvement in bronchial reactivity (change in eCO (parts per million) per natural log unit change in bronchial hyperreactivity 0.498, 95% confidence interval 0.071 to 0.924, P=0.024). These findings suggest that, contrary to previous data, there is no cross-sectional relationship between eCO and lung function or bronchial reactivity, but that there may be a longitudinal trend with bronchial reactivity that is worth further investigation.