A recent meta-analysis comparing ICS with SCS; or ICS and SCS combination to placebo and SCS combination in the Emergency Room (ER), included 17 different randomized double blind placebo controlled trials with data for 1,133 subjects (470 adults and 663 children) were available for analysis. It concluded that ICS presents early beneficial effects (within 1 to 2 h) in terms of clinical and spirometric variables when used in 3 or more doses administered in time intervals ≤ 30 min over 90 to 120 min. ICS lead to a significant reduction in admission rate at 2 to 4 hours with only 10 subjects needed to be treated to prevent one admission. The nongenomic effect was suggested as a possible candidate by covering the link between molecular pathways and the clinical effects of CS. However, this issue remains controversial and the current asthma guidelines published by the National Heart, Lung, and Blood Institute (NHLBI) in the USA do not include the use of inhaled glucocorticoids in the treatment of asthma in the ER, while the Global Initiative for Asthma (GINA) guidelines suggested that it can be effective. This subject clearly needs to be studied further.