Rationale The Breathing Counts Program aims to increase the health and wellness of underserved asthmatic children and their families. Breathing Counts is centrally located in Bayview Hunters Point–a predominately African-American, disenfranchised neighborhood in southeast San Francisco with many surrounding environmental toxins, a lack of continuous and accessible health care, and a disproportionately high asthma rate. Breathing Counts strives to provide residents with reliable and acceptable health education and referrals as essential components of their asthma management. Methods School-based education provides culturally- and age-appropriate curricula to young asthmatics attending local public and private schools. Community Health Workers conduct outreach through community health fairs, parent advisory meetings, and door-to-door outreach at homes and local businesses. Lastly, one-to-one training empowers adult community members to serve as local asthma experts. Results Each year, Breathing Counts reaches approximately 10,000 local residents, who become more knowledgeable about a serious, yet manageable condition that may affect them or someone close to them. Staff has been able to integrate within the public school system–augmenting existing services at approximately 10 schools in the neighborhood–as well as the housing authority–collaborating to effectively combat asthma allergens in low-income housing. Conclusions Breathing Counts is fostered by a high amount of trust among local residents, strong ties with other community organizations, and a continuum of services with the educational, medical, social, and political systems. In the near future, Breathing Counts hopes to offer more services to afford local asthmatics increased opportunities for enhanced health education, social support, and empowerment.