Preadolescence involves cognitive, social, and physiological changes along with changes in the child's environment. During this developmental stage, young adolescents are transitioning into middle school, forming a larger social network, and managing parental expectations for assuming more responsibility for self-care. The impact of these developmental changes on asthma management is not well understood. The purpose of this study was to better understand asthma and asthma management from the perspective of middle school students. A partnership was formed between the university researcher, several school nurses, and a representative of the health department, through the Orange County Asthma Coalition. Funds were secured from the American Lung Association. School nurses helped to identify and recruit 50 middle school students with asthma to participate in focus groups. The focus-group discussions centered on asthma management with implications for intervention development. Analyses sought to identify developmental issues that affect management. Results indicated that the transition to middle school represents a challenge to managing asthma. As compared with the elementary school environment, support structures are broader and more diffuse, physical education is more demanding, and peer pressure is greater. Nevertheless, the desire for greater autonomy and independence in self-care was strong, particularly among eighth graders. Most interventions are designed for either children or adults, without recognizing the important developmental changes that are occurring in preadolescents with implications for asthma management. A school-based intervention in middle school may help students with asthma transition to greater autonomy of care, while easing transition in other domains of life.