BACKGROUND: Adults who have had an admission for severe life threatening asthma are at high risk of future attacks or death. Optimal self management is the key to reducing this risk but relies on people recognising the severity of symptoms and engaging in specific health care behaviour. METHODS: We used a focus group to examine self management beliefs, attitudes and behaviours in five adults admitted to hospital for asthma. RESULTS: There were a number of themes. Patients delayed seeking medical attention until asthma symptoms were severe despite ownership of a peak expiratory flow meter, written plan, or experience of previous attack. DISCUSSION: Insight into the significance of the severity of symptoms and need to change self management behaviour in response to symptoms is key to reducing the risk of future attacks. The general practitioner has a key role in determining and addressing self management behaviour and attitudes that place patients at risk.