Summary: Bronchoconstriction represents a distinct feature of chronic obstructive lung diseases including COPD and asthma. Cholinergic contractile tone is increased in inflammation in asthma, thus short (SAMA) and long acting muscarinic antagonists (LAMA) play an important role in the management of this disease. Glycopyrronium provided significant bronchodilation and bronchoprotection in methacholine challenge model in asthmatic subjects. Several studies evaluated clinical efficacy and safety of new LAMAs, including glycopyrronium bromide, in triple fixed combinations (LAMA/LABA/ICS) in one inhaler. Fixed combination of extrafine beclomethasone dipropionate, formoterol fumarate, and glycopyrronium bromide (BDP/FF/GB) in pMDI was found to significantly improve lung function and to reduce the rate of moderate and severe exacerbations by 15% in TRIMARAN and by 12% in TRIGGER trial. In conclusion, there is now substantial evidence of high efficacy and optimal safety profile of glycopyrronium in asthma that is uncontrolled despite treatment with an ICS/LABA combination. LAMAs as add on to current therapy may be of value in several cohorts of asthmatics, including but not limited to asthma/COPD overlap, frequent exacerbators, patients with significant mucus production or those with steep decline in lung function. This regimen is highly recommended by GINA and European Respiratory Society (ERS) guidelines as an optimisation step for patients with severe asthma before introduction of any biologic treatment or systemic corticosteroids.