The British Thoracic Association conducted a confidential inquiry into death from asthma in adults aged 15-64 years in the West Midlands and Mersey Regions in 1979. Ninety patients were identified as having died of asthma. The 86 for whom sufficient information was available have been classified according to their atopic status: 52 (60%) were judged to be atopic and 34 non-atopic. A history of rapidly progressing severe asthma attacks and death within an hour of onset of the fatal attack was more frequent among the atopic patients. Half the atopic patients died in the 4 months May/June and September/October; in contrast almost half of the non-atopic patients died in the 4 months January to April. Half the atopic patients died at weekends whereas for non-atopic patients death was distributed evenly throughout the week. Respiratory infection was the most frequently recognized trigger of the fatal attack in both groups of patients. No trigger was recognized for 55% of patients (atopic 65%, non-atopic 40%).