OBJECTIVES: Asthma is a chronic  disease afflicting more than 300 million people throughout the world . Our aim was to examine the availability, pricing and affordability of asthma medicines in Tehran. METHODS: We followed the methodological recommendations developed of the World Health Organization and Health Action International on measuring medicine prices, availability, affordability and price components. Data was collected from a random selection of 30 public sector facilities and 90 private sector retail pharmacies in 22 districts  of Tehran in September 2012. RESULTS: Inhaled Corticosteroids was found in over 25% of the pharmacies. The availability of oral corticosteroids and short acting beta agonists was poor in all districts of Tehran.  Locally manufactured most commonly prescribed medicines (beta-agonist and corticosteroid sprays) were affordable as the of cost of one month utilization was about 0.3 of one day (equivalent to one day) earning for the unskilled worker for the insured (uninsured). However the availability of the asthma medicines were limited and ranged from less than 5% (for the imported sprays) to about a third (for the locally manufactured sprays) of the outlets. CONCLUSIONS: The poor availability of inhalers at public facilities affects those patients who depend on these facilities for treatment and medications. In relation with imported asthma medicines, results indicate access to asthma medicine has been reduced in most medicines, perhaps due to the international sanctions that affected the country in 2012.  Further interventions are required to improve access to asthma medicines at the times of financial hardship and international sanctions affecting the ability of the importers and producers to provide medicines.