OBJECTIVES:  Asthma disease needs a long term management in order to maintain optimum asthma control. In addition to routine follow-ups (maintenance), patients are vulnerable to acute exacerbations that may warrant urgent visits and hospitalizations. This study aimed to measure the costs incurred in a public suburban Malaysian hospital for a maintenance visit, an urgent visit to the emergency department (ED), and a hospitalization due to asthma, from the hospital’s perspective. METHODS: The cost centers involved were identified first: the respiratory clinic and outpatient pharmacy (for maintenance visit); the non-severe zones in ED (severe zone was excluded due to accessibility issue) and ambulatory pharmacy (for ED visit); the adult medical ward and inpatient pharmacy (for hospitalization). Using the activity-based micro-costing approach, the following steps were taken in sequence: identification and measurement of the activities involved in each cost center, and valuation of the activities (unit cost sources from the hospital and national pricing database). The sample sizes were 15 for costing maintenance and ED visits, and 50 for hospitalization – greater variability in costs was expected for hospitalization. The total mean costs were expressed in US Dollar ($) 2014. RESULTS:  The mean (SD) costs were: $43.19 (9.99) per maintenance visit, $11.63 (2.21) per ED visit, and $552.13 (303.41) per hospitalization. Ward admission and maintenance medications were the two largest cost components. CONCLUSIONS: The costs per asthma-related event were measured. Although the cost per ED visit seemed low, it was limited to non-severe cases only. Meanwhile, the cost per hospitalization has exceeded the total health expenditure per capita 2014 in Malaysia ($456) by 17%. Given the high expenditure per hospitalization in this suburban hospital, the maintenance management has to be optimized in order to reduce the risk of exacerbation that leads to hospitalization.