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Associations between thunderstorm activity and asthma morbidity have been reported in numerous locations around the world.1 The most prominent hypotheses explaining the associations are that pollen grains rupture by osmotic shock in rainwater, releasing allergens, and that gusty winds from thunderstorm downdrafts spread particles and/or aeroallergens, which may ultimately increase the risk of asthma attacks. A full understanding of “thunderstorm asthma” is crucial, especially with projections of increases in heavy rainfall, thunderstorm events and aeroallergen concentrations as the climate system warms.2 ,3 Many existing studies of this phenomenon have been limited in power and scope.1 Our study seeks to conduct the most extensive investigation of thunderstorm occurrence and asthma morbidity to date in a region, the Southeast US, that has not previously been examined but where …