Nearly 200,000 patients are admitted to the hospital each year in the United States for acute asthma exacerbations.  Approximately 2% of patients are intubated and placed on mechanical ventilation. In-hospital mortality is nearly 100 times higher when a patient with acute asthma exacerbation is intubated.  Non-invasive positive pressure ventilation is well known to improve outcomes for patients with an acute COPD exacerbation or with acute cardiogenic pulmonary edema. In contrast, the data on NIPPV for acute asthma is limited and remains debated. In this podcast, we discuss the latest study on the use of NIPPV in acute exacerbations of asthma.