This monograph aimed to investigate the role of asthma severity, health services utilisation and medication use in frequent ER attendance for asthmatics in Palestine and designed as cross-sectional study using a previously developed questionnaire. The results indicated that about 121 asthma patients, 73.5%, were frequent ER attendees during the previous year, with a mean 6.7 visits (standard error 0.75). Moderate/severe asthma and hospital admissions in the previous year due to asthma were the strongest predictors for frequent attendees (adjusted OR [AOR] 6.92, 95%CI 2.44-19.62 and 11.16, 95%CI 4.37-28, respectively). Frequent attendees reported more difficulties in using asthma inhalers compared to one-time ER attendees (AOR 2.49, 95%CI 1.04-5.99). Inhaled short-acting beta(2)-agonists were reported to be used regularly, on most days, by frequent attendees (>or=1 canister/month) compared to one-time attendees (AOR 4.4, 95%CI 1.28-15 and 4.05, 95%CI 1.33-12, respectively). We concluded that the lack of proper use of inhalers and an over-reliance on reliever therapy contribute to asthma morbidity. Intervention programmes at the patients and professionals levels are recommended.