Extensive research has advanced both bronchoscopic and non-bronchoscopic treatments for asthma. Bronchoscopic treatments, such as bronchial thermoplasty (BT) (Cox, N Engl J Med 356:1327–1337, 2007), and targeted lung denervation (TLD) (Hartman, Respiration 101:184–189, 2022) have shown significant promise. BT is particularly effective in reducing airway smooth muscle, thereby decreasing airway narrowing due to bronchoconstriction. Clinical studies have demonstrated that BT provides sustained benefits for up to 10 years, including fewer exacerbations and improved quality of life, particularly for patients on high-dose inhaled corticosteroids and long-acting beta-agonists (Wechsler, J Allergy Clin Immunol 132:1295–1302, 2013). TLD has shown promise for the future treatment of obstructive lung disease; however, it remains investigational and has not yet received FDA approval. TLD, which disrupts parasympathetic nerve input to reduce bronchoconstriction and mucus production, has shown early promise in improving lung function and reducing exacerbations in severe asthma (Hartman, Respiration 101:184–189, 2022). Additionally, non-bronchoscopic treatments such as biologics (e.g., anti-IL-5, anti-4/13, and anti-TSLP therapies) are used either in combination with bronchoscopic treatments or when biologics alone are not effective, targeting specific inflammatory pathways and offering substantial improvements in asthma control (Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention (2024 update). Available from ginaasthma.org ). Overall, bronchoscopic treatments like BT and TLD, alongside biologics, offer promising options for improving management of severe asthma, with BT notable for its FDA approval, long-term benefits, and cost-effectiveness.