One hundred eight-two atopic patients were skin tested with cockroach antigen. Of these 182 patients, 54.9% gave positive immediate skin reaction by intracutaneous test. Among those atopic patients tested, 57.5% of patients with asthma and 50.7% of patients with allergic rhinitis were sensitive to cockroach extracts. The specific IgE antibody was determined by fluoroallergosorbent test. Of 79 cockroach-positive atopic patients, 39.2% were found to contain IgE antibodies against cockroach. No specific IgE was detected in cockroach-negative atopic and nonatopic subjects. Bronchial provocation test with cockroach antigen was performed on 15 subjects. Immediate asthmatic response was detected in six of nine cockroach-positive subjects with asthma. Two cockroach-negative subjects with asthma and four nonatopic subjects demonstrated no significant decrease in FEV1. The results indicate that cockroach induces antigen-specific IgE-mediated bronchial asthma, and cockroach is one of the major causes of allergic asthma.