The aim of this study was to assess health-related quality of life (QoL) in elderly subjects with a diagnostic label of asthma from a general practice population, and to determine the main contributory factors. Sixty people aged > or =70 yrs with a primary care diagnostic label of asthma, and 43 control subjects were recruited. Assessment of bronchodilator response, and oral steroid trials were conducted where possible. The main outcome measures were QoL scores for the Short Form (SF)-36 and the St George's Respiratory Questionnaire (SGRQ). In the asthma group, 29 subjects demonstrated a significant airway response to bronchodilators or steroids. Mean SF-36 scores were significantly worse in the total asthma group for components of physical function, physical role limitation, and general health, although psychological scores were similar. QoL remained worse than controls in those subjects with a significant bronchodilator response. Dyspnoea and depression accounted for 61% of the variance in the SGRQ, but forced expiratory volume in one second was not an independent variable. Quality of life is impaired in elderly people with a diagnosis of asthma, including those with demonstrable airway variability. Many older subjects with asthma note a variety of symptoms, highlighting the need for further research into the adequacy and efficacy of their treatment.