Severe asthma exacerbation causing respiratory failure remains a potentially reversible, life-threatening condition that imposes significant morbidity and mortality. About 10% of asthmatics admitted to hospital go to intensive care unit (ICU), with 2% being intubated. ICU admission identifies an asthmatic patient as a member of a poor prognostic group. Death is most commonly a result of one of the complications of airflow obstruction and severe gas trapping. Barotrauma, hypotension and refractory respiratory acidosis are complications of asthma. When severe asthma does not respond to medical therapy, we must intervene fast to provide adequate oxygenation and ventilation. Noninvasive ventilation is possible that some patients with severe asthma may benefit from NIV. Invasive ventilation is the objective of initiating invasive ventilation is to limit gas trapping by controlled hypoventilation. This chapter also comprises of well-illustrated figures on dynamic hyperinflation in setting of severe airflow obstruction and Flow waveform demonstrates gas trapping. The decelerating expiratory limb fails to reach the baseline before the next breath begins (circled), preventing complete emptying of the lung.