CASE PRESENTATION: A 60-year-old woman presented with right-sided pleuritic chest pain, productive cough, and dyspnea for 2 days. She had asthma for 20 years requiring multiple hospitalizations. She was a non-smoker and her outpatient medications included a long acting beta-agonist/corticosteroid inhaler, montelukast, and short acting beta-agonist as needed. On exam, she was not in respiratory distress, breath sounds were diminished at the right lung base and minimal bilateral expiratory wheezing was noted. Chest roentgenogram showed a triangular haziness at the right lung base obscuring the right heart border and right hemidiaphragm suggestive of right lower lobe (RLL) and RML atelectasis (Figure 1). Bronchoscopy showed complete mucus plugging of the RML and RLL bronchial orifices that reopened after suctioning. In the past 16 months, the patient had 5 hospital admissions for asthma exacerbation with lobar atelectasis involving separately each one of the three lobes of the right lung and twice involving the RML and RLL at the same time (Figure 2). Atelectasis resolved after bronchoscopic removal of mucous plugs on those episodes. During this admission, the patient had significant clinical and radiographic improvement after bronchoscopy. She was discharged with her asthma medications and VEST chest physiotherapy at home.