Since asthma is frequently encountered in the primary care setting, it is important to distinguish uncontrolled or difficult-to-control asthma from severe asthma. Severe asthma is defined as asthma that is uncontrolled despite adherence with an optimised high-dose combination of inhaled corticosteroids (ICS) and long-acting beta-agonists (LABA) therapy, or that requires high-dose ICS–LABA to remain controlled. This article highlights simple decisions and diagnosis steps that may help primary care physicians and general practitioners to identify patients who could benefit from tertiary care specialist assessment once other factors, such as inhaler technique, adherence, and comorbidities have been evaluated. It also briefly discusses the impact of oral corticosteroids (OCS) use and the challenges of the COVID-19 lockdown on asthma management.