Approximately 196,000 hospitalizations occur each year among the 9 million U.S. children who have been diagnosed with asthma. This study attempts to find out how many of those hospitalizations might have been prevented and how. A survey was conducted of parents, primary care physicians (PCPs) and inpatient attending physicians (IAP) of children admitted for asthma in an urban hospital over a period of 14 months. The 230 hospitalized children had a median age of 5 years; most were poor, non-white and had public or no health insurance. Twenty-six percent of parents reported that their child's hospitalization was preventable, compared with 38 percent of PCPs and 43 percent of IAPs. PCPs and IAPs were more likely to cite parent/patient-related reasons than the parents (83% vs. 67% vs. 44%, respectively). Among the parent/patient related reasons, medication issues were identified as the major cause, including not taking prescribed medications. The consistent failure to avoid known triggers, such as cigarette smoke, was frequently identified as a cause by all three sources. Failure to obtain follow-up medical care also was identified by both physician groups as a risk factor. Parents and IAPS more than PCPs cited physician-related reasons, including lack of education about the child's condition and better quality of care.