Severe asthma in South Africa (SA) is underappreciated, especially in the primary care setting. This study highlights the epidemiological context of severe asthma as a phenotypic variant. Primary care practitioners, as first-contact medical providers, need grounding in the management of severe asthma based on the precision of diagnosis and negotiated along the 10-point strategy. The underdiagnosis and undertreatment of asthma ought to inform educational programmes and research in this country.