Asthma is a heterogeneous chronic inflammatory lung disease originating from a complex interaction between individual and environmental factors. As consequence of world population ageing an increase of chronic diseases prevalence, including asthma, has been documented. Late-onset asthma may have more complex pathogenic mechanisms other than Th2-mediated pattern. Diagnosis in older subjects is not straightforward as consequence of poor symptoms perception; in adults co-morbidities are associated with different asthma outcomes. A careful assessment and management of all potential concurrent disorders is essential to achieve a better disease control and an adequate response to treatment in elderly asthmatic patients.