A case report of respiratory arrest in a patient with an out-of-hospital, near fatal asthma (NFA) attack; successfully resuscitated with treatment that included endotracheal adrenaline is described. This report demonstrates that endotracheal epinephrine (adrenaline may have a role in the resuscitation of asphyxic asthma. Adrenaline is a recognised β2 agonist and its smooth muscle relaxation properties are known to reverse bronchospasm. Ventilating patients with severe bronchospasm resulting from asphyxic asthma is known to be difficult. This report shows that instilling adrenaline via the endotracheal tube to a patient in cardio-respiratory arrest, resulted in relief of bronchospasm, reduction in airways resistance and a subsequent improvement of the operator's ability to ventilate.