The authors discuss a study published within the issue on evidence-based bronchodilator therapy for obstructive airway disease. Topics include the use of metered-dose inhaler (MDI) and valved holding chamber (VHC) for bronchodilator and corticosteroid therapy, the U.S. Food and Drug Administration's guidance for MDI use, and bronchodilator therapy with the pressurized MDI and VHC in the emergency department.