Our study evaluated the ability of early peak expiratory flow rates (PEFR) to be predictive of hospital admission while double blinding the measurements and using a standardized treatment protocol and specific admission criteria. The measurements were recorded prior to and after initial therapy. Eighty-six acute asthmatic episodes in 51 patients were analyzed. Nine (10.5%) of the episodes resulted in hospitalization; 77 (89.5%) resulted in discharge. No correlation with admission was found for the initial PEFR, a second PEFR following treatment, or the differences between these two values. Our study indicates that early PEFRs alone are not useful predictors of the need for hospital admission. Although a significant number of patients in our study population presented with severe airflow obstruction, they responded sufficiently to treatment to permit discharge.