Asthma is one of the most common chronic diseases of childhood. Those particularly affected are young, poor, African American children. Moreover, rates of ED visits, hospitalizations, and mortality are substantially higher for black children (Akinbami, 2006). Despite the ample published research on asthma prevalence and asthma management interventions, there is little research available on barriers to asthma care among urban low-income families as perceived by children with asthma and their caregivers. This qualitative study analyzed focus group data from five focus groups conducted with 28 participants in metropolitan Atlanta. This study found caregiver and child health beliefs and perceptions concerning the usage of daily controller medications to be a significant barrier to asthma care. Barriers to environmental control consisted mostly of financial constraints making environmental remediations difficult. Psychological distress was prevalent among both children and caregivers demonstrating the burden endured from managing a chronic illness.