In 10- to 13-year-old children with asthma, we know less than is desirable about the nature of the disease management tasks they face as youngsters approaching adolescence. This article reviews aspects of asthma management in youngsters at a time of significant transition. They experience puberty and growth spurts. Their cognitive abilities enable more abstract thinking. They seek individuation from their parents and socialization with peers. These factors influence asthma outcomes, including symptom control, health care use, and school attendance and performance. Furthermore, significant sex- and gender-related differences in outcome exist. Those with asthma who are 10 to 13 years of age contend not only with the particular management demands their chronic condition imposes on them but also the challenges associated with maturation. Most asthma management interventions do not account for the challenges faced at this transitional phase, and developmentally appropriate programs are needed.