Although inhaled corticosteroids have been recommended, there are no published reports of triamcinolone acetonide therapy for asthma during pregnancy. The objective of this study was to report our experience with triamcinolone acetonide during pregnancy. This was a retrospective cohort study in a tertiary care urban hospital. We compared birth weights and the proportion of subjects hospitalized for asthma exacerbations among pregnant women receiving inhaled triamcinolone acetonide, inhaled beclomethasone dipropionate, and oral theophylline. The mean triamcinolone acetonide group (n = 15) birth weight was 502 g more than the beclomethasone group (n = 14) and 316 g more than the theophylline group (n = 25); however, these differences were not statistically significantly. Fewer patients treated with triamcinolone acetonide (n = 5, 33%) required hospital admissions for asthma exacerbations compared to those treated with beclomethasone (n = 11, 79%; P < 0.05) but not theophylline (n = 7, 28%; P = NS). Our preliminary data suggest that triamcinolone acetonide appears to be at least as efficacious for the treatment of asthma during pregnancy as is beclomethasone. These results should be confirmed by a clinical trial to further evaluate the safety and efficacy of inhaled triamcinolone acetonide during pregnancy.