OBJECTIVES: To evaluate the health care resource utilization and economic burden of asthma in the US Veterans Health Administration (VHA) population.  METHODS: A retrospective data analysis was performed using VHA claims from October 1, 2009 through September 30, 2014. Asthmatic patients were identified using the International Classification of Diseases, 9^th Revision, Clinical Modification diagnosis code 493. The diagnosis date was designated as the index date. A comparison cohort of patients without an asthma diagnosis was created for patients of the same age, gender, race, index year, and baseline Charlson Comorbidity Index score. A random index date was chosen for the comparison cohort to reduce selection bias. Patients were required to have continuous medical and pharmacy benefits 1 year pre- and post-index date. One-to-one propensity score matching (PSM) was performed to compare follow-up health care costs and utilization between the cohorts, adjusting for demographic and clinical characteristics. RESULTS: Eligible patients (N=253,302) were identified for patients with and without asthma. After 1:1 PSM, 75,214 patients were matched from each cohort, and the baseline characteristics were well-balanced. Asthmatic patients were more likely to utilize health care resources than non-asthmatic patients, including inpatient (8.50% vs. 3.48%, p<0.0001); outpatient (99.73% vs. 74.76%, p<0.0001), and pharmacy visits (90.91% vs. 65.94%, p<0.0001). Higher health care resource utilization translated to higher costs for asthmatic patients than non-asthmatic patients, including inpatient ($2,314 vs. $999, p<0.0001), outpatient ($4,435 vs. $2,803, p<0.0001), pharmacy ($747 vs. $511, p<0.0001) and total costs ($7,496 vs. $4,313, p<0.0001). CONCLUSIONS: The economic burden and health care resource utilization was significantly higher for patients in the US VHA population who were diagnosed with asthma compared to those without asthma.