Background: Respiratory disease is common in people with intellectual disability (ID). The inhaled route is preferred for medication administration in treating respiratory diseases including asthma. Cognitive, physical and sensory impairments of people with ID often necessitate assistance with medication taking; in supported accommodation this is provided by direct support professionals (DSPs). Method: A qualitative study design was used to explore DSPs experiences with asthma medication management. Data were collected via in-depth, semi-structured, face-to-face or telephone interviews. Results: Key findings included the complex balance of duties undertaken by DSPs, and a lack of consistency in asthma management processes across sites. Conclusions: This exploratory research suggests that DSPs are involved in asthma management and required to use clinical judgement, but are not provided with education and tools to manage asthma in, and foster correct inhaler use by, their clients. This highlights the need for tailored guidelines that integrate with NDIS principles.