In summary, several studies have reported stabilisation or even decreased asthma prevalence over the last 5-10 years. These observations are unlikely to be completely attributable to improved asthma management, but may, in fact, be due to a decrease in incidence as demonstrated by Bollag et al.4 The reasons for this decrease are unclear and cannot easily be explained by the current hygiene hypothesis. It will be of great interest to see whether the decrease in asthma incidence and prevalence will be confirmed in other studies, and if so, whether this trend is the beginning of the end of the asthma epidemic. © The Author 2005; all rights reserved.