Objective: To analyze school attendance and school achievement as outcomes of the care of children with asthma. Methods: A previously identified Rochester, Minnesota, cohort of children with asthma and age- and sex-matched children without asthma were studied. School attendance, standardized achievement test scores, grade point average, grade promotion, and class rank of graduating students for children with asthma and control subjects were obtained from the Rochester Public School system. Results: Children with asthma (n = 92) and age- and sex-matched non-asthmatic control subjects with 640 school-years of observation were studied. Children with asthma had 2.21 (95% CI, 1.41 to 3.01) more days absent than children without asthma. There was no significant difference in standardized achievement test scores (reading percentile difference 1.22% [95% CI, –3.68 to 6.12], mathematics percentile difference 2.36% [95% CI, –2.89 to 7.60], language percentile difference 2.96% [95% CI, –4.03 to 7.15]). There was no significant difference in grade point average, grade promotion, or class rank of graduating students. Conclusion: In this community, although children with asthma had 2 excess days of absenteeism, the school performance of children with asthma was similar to that of children without asthma. (J Pediatr 2001;139:278-83)