Asthma is the most common long-term respiratory condition seen in pregnancy, affecting approximately 2–13% of pregnant women worldwide. Inadequate asthma control has been linked to higher risks of maternal and fetal complications, including preeclampsia, preterm delivery, low birth weight, congenital anomalies, and perinatal death. Pregnancy triggers a range of mechanical, hormonal, and immunological alterations—such as upward displacement of the diaphragm, changes in lung volumes, elevated progesterone and estrogen levels, and a shift toward a Th2-dominant immune profile—which may lead to improvement, deterioration, or no significant change in asthma control. Conversely, asthma-related airway inflammation, hypoxia, and systemic effects can adversely affect placental function and fetal development. This chapter reviews the bidirectional interaction between asthma and pregnancy, diagnostic considerations, monitoring strategies, and evidence-based pharmacologic and nonpharmacologic management approaches. Ensuring safe and effective management depends on continuing inhaled corticosteroids, using β₂-agonists correctly, and tailoring additional controller therapies—such as leukotriene receptor antagonists, theophylline, or omalizumab—based on individual needs and clinical indications. Acute exacerbations require prompt recognition and intervention with inhaled bronchodilators, corticosteroids, oxygen supplementation, and multidisciplinary care. Labor and delivery management emphasizes continuation of asthma therapy, avoidance of bronchoconstrictive agents, and appropriate analgesia. Effective control through stepwise therapy, patient education, adherence reinforcement, and trigger avoidance remains the cornerstone of optimizing maternal and neonatal outcomes.