Background: There is a large body of research suggesting the role of school-based health centers (SBHCs) in improving outcomes for children with asthma, but there are no evidence-based guidelines for the care of children with asthma in SBHCs. We conducted a randomized trial to assess screening in children with asthma in an urban SBHC. Methods: Participants were screened for asthma triggers. The intervention group received home assessments and medical legal partnership (MLP) referrals as indicated. The primary outcome of asthma severity was assessed using the asthma control test (ACT). All participants completed semi-structured interviews to evaluate their experience. Results: All families randomized to intervention qualified for and completed home remediation. There were no statistically significant differences in asthma severity. There was 100% retention of participants, and all participants rated their experience as good or excellent. Implications for School Health Policy, Practice and Equity: This study demonstrates a high prevalence of home-based asthma triggers for children with asthma who receive care in SBHCs. Although not large enough to demonstrate significance in primary outcomes, participants were successfully recruited from a diverse population and retained through completion of the study. Participants rated their experience as good or excellent, suggesting that the recruitment and retention of diverse participants for clinical trials in SBHCs can be successful. Conclusions: Home-based asthma triggers for children with asthma who receive care in SBHCs are prevalent. Although complex collaborations are required, SBHCs are a viable site for clinical trials. More research is needed to understand the benefit of interventions in SBHCs to reduce asthma severity.