OBJECTIVES Asthma is the most common chronic disease in childhood, reduces the quality of life of children and their families, and produces high social and health care costs. The aim of this study was to estimate the direct cost of pediatric asthma in Turkey and to examine its variability depending on asthma control level. METHODS The clinical pathway for childhood asthma was designed by and based on the data from the available Turkish literature. Unavailable data was collected by the expert’s clinical view. To calculate direct costs, the medical management of childhood asthma estimated using 'cost-of-illness' methodology for one year per child. All costs were calculated from the health care payer perspective. The costs were covered hospitalizations, physician visits, diagnostic tests, medications and co morbid diseases. RESULTS According to the recent studies, the controlled patient was 60%, partial controlled patient was 25%, and uncontrolled patient was 15% in Turkey. The cost of asthma calculation was based on weight of control. The mean annual cost per patient with controlled asthma is  542.97€, partial controlled asthma 714.52€ and uncontrolled asthma 1047.86€. Hospitalizations, physician visits, diagnostic tests, co morbid diseases costs and medication costs estimated 4 %, 21%, 7%,  27%, 40% of total costs for controlled patient, 27%, 16%, 5%, 21%, 31% of total costs for partial controlled patient and 50%,11%, 4%, 14%, 21% for uncontrolled patient respectively. CONCLUSIONS The direct cost of pediatric asthma in Turkey increases depending on disease control level along with different spectrum of item distributions . To increase the utility and effectiveness  of  healthcare system, the findings of this evaluation may guide to construct  future policies.