Background: It has been shown that adhesion molecules play an important role in the development of inflammation of bronchial asthma. The purpose of this study was to assess the role of inhaled steroid, inhaled long acting B-2 and inhaled sodium cromoglycate in bronchial asthma by measuring their effect after 3 month of therapy in separate groups on pulmonary function, blood eosinophil, inflammatory cells in BAL, ICAM-1 in BAL and serum and total Ig-E in serum. Methods: This study was carried in Kasr El-Aini Hospital, Cairo University, where 55 subjects (10 control and 45 asthmatics) participates. They were divided into the following group:- Control group (10 normal subjects), Group A (15 asthmatics received inhaled steroid for 3 months), Group B (15 asthmatics received inhaled long acting B-2 for 3 months) and Group C (15 asthmatics received inhaled sodium cromoglycate for 3 months). All participants were subjected to full history taking, clinical examination, full blood count, pulmonary function tests, bronchoscopy and broncho-alveolar lavage, detection of serum total Ig-E and ICAM-1 in serum and in BAL for all groups. These measures were repeated after 3 months of therapy. Results: Total Ig-E and serum ICAM-1 were raised in serum of asthmatics. FVC, FEV-1 and PEFR were sig. increased in asthmatic on long acting B-2 inhaler. Eosinophil count in blood was sig. reduced in asthmatic on inhaled steroids. Inflammatory cells in BAL were sig. reduced in asthmatic on steroid inhaler. Also, serum ICAM-1 was reduced on steroid inhaler. Conclusion: sICAM-1 is one of the inflammatory mediators. Inhaled steroids are effective in controlling asthma symptoms, improving pulmonary function tests and reducing inflammatory mediators if received for longer duration. Inhaled long acting B-2 is effective in controlling asthma symptoms. While inhaled sodium cromoglycate is used as prophylactic treatment.