Refractory asthma is defined as asthma that is not well controlled after at least 3-6 months of standardized treatment with two or more controller medications including inhaled medium to high dose glucocorticoids and long-acting beta2 agonists. The diagnosis and evaluation of children with refractory asthma should follow the following basic procedures: 1. determine the presence and severity of reversible airflow limitation; 2. determine the adequacy of medication, medication compliance and mastery of inhalation techniques; 3. determine the presence of risk factors associated with or exacerbating asthma, such as gastroesophageal reflux, obesity with or without obstructive sleep disorder, allergic rhinitis or sinus disease 4. differential diagnosis with other diseases with symptoms such as cough, dyspnea and wheezing; 5. repeated assessment of the child’s level of control and response to treatment. Compared to adults, the rate of hormone-resistant asthma in children is much lower. Therefore, the diagnosis of refractory asthma in children should be made with caution and carefully evaluated in light of the above.