Objective: To investigate the diagnosis and management of gastroesophageal reflux (GER)-associated asthma due to superior mesenteric artery syndrome (SMAS). Methods: The clinical data of 6 cases of GER-associated asthma caused by SMAS were retrospectively analyzed. Results: Of the patients, the main clinical manifestations included intermittent upper abdominal bloating pain, acid regurgitation, heartburn, cough and asthma, and upper gastrointestinal contrast showed compression of the horizontal part of the duodenum; 2 cases received conservative treatment, and 4 cases had surgical treatment. Follow-up ranged from 1.5 to 84 months; of the postoperative patients, the symptoms in 3 cases were improved, and one case developed gastroplegia which was relieved by gastric motility-promoting drugs. The symptoms in the two patients receiving conservative treatment were effectively controlled, but long-term treatment with proton pump inhibitors and gastric motility-promoting drugs were required. Conclusion: Both SMAS and GER should be taken into consideration in diagnosis and treatment of GER-associated asthma caused by SMA, and satisfactory results may be achieved by surgical or conservative treatment.