OBJECTIVES: It is hypothesised that patient satisfaction with the features of an asthma inhaler directly influences compliance behaviour of asthma patients. This study investigated the relationship between physician-reported compliance of 1400 asthma patients with the degree of patient-reported satisfaction with their inhaler.  METHODS: Data were drawn from the Adelphi Disease Specific Programme (DSP) in Asthma, a cross-sectional study of consulting patients undertaken in 2009. Data were collected from physicians for each patient and collected directly from consenting patients. Key factors analysed were physician-reported perceptions of patient compliance on a 1-5 scale (where 1 is 'not at all compliant' and 5 is 'fully compliant') and data for patient-reported satisfaction with their inhaler including specific device features associated with convenience, dosing and inhaler mechanism. The results were tested against potential confounders including age, gender, ethnicity and current asthma severity, to ensure the relationship effect between compliance and satisfaction was distinct. RESULTS: There was a significant relationship between the physician-reported level of compliance and patient-reported satisfaction with their inhaler device. The investigators observed that a better perceived level of compliance was directly associated with a higher level of inhaler satisfaction (P <0.001). Those inhaler features associated with convenience: 'built to last/will not break easily’; ‘easy to hold and carry', 'instructions are simple and easy to follow', and 'no need to put the drug into the inhaler before use' accounted for four of the top five drivers of overall satisfaction. CONCLUSIONS: Patient satisfaction with features of their inhaler is an important factor in promoting patient compliance. If physicians made particular effort to select an inhaler that satisfies the patient, including attention to features associated with convenience, patient compliance with their asthma treatment would be expected to improve.