Inhaled corticosteroids are the mainstay of preventive asthma therapy, and have proven benefit in terms of reducing the rate of asthma exacerbations and the use of rescue medication. However, there is ongoing debate over the risk-benefit profile of this group of drugs, despite their widespread use for 20 years and 1 billion treatment years' experience. It seems surprising that the issue of safety is still being discussed, as almost any other treatment that had such extensive clinical experience would be widely accepted as safe, commented Dr Søren Pedersen from the University of Southern Denmark, Kolding, Denmark. In line with the widespread clinical interest in the tolerability of inhaled corticosteroids, particularly in paediatric patients, the issue was discussed in a number of presentations at the 58th Annual Meeting of the American Academy of Allergy, Asthma and Immunology (AAAAI) [New York, US; March 2002]. After considering the effects of inhaled corticosteroids on bones, adrenal function and growth, the general consensus appeared to be that the potential benefits outweighed the risk of adverse events in the majority of patients.