Bhatia R, et al. - Via this retrospective chart review, researchers focused on the clinical usefulness as well as the efficiency of methacholine challenge testing (MCT) as a tool to assess pediatric asthma at a tertiary center. This study included 172 individuals (91 Females, age range 5–21 years). “Unlikely” “likely”, and “very likely” were 3 assigned asthma probability categories. Of the overall participants, negative and positive MCT results were 64.9% (n = 111) and 35.1% (n = 60), respectively. One was inconclusive. Being shorter, lighter, younger and having lower forced expiratory volume in one second/forced vital capacity ratio were the features of participants who tested positive vs those who tested negative. The likelihood to test positive was less among those with exercise symptoms only. The certainty of the presence or absence of asthma was increased by MCT in a majority of people. Provided an individual’s pretest probability of asthma and provocative concentration (PC₂₀) was considered, MCT could display utility in assessing pediatric asthma. It did not demonstrate utility for people with exercise symptoms only.