The GINA treatment strategy released in 2019 included an important change disrupting a fundamental practice in mild asthma management. Treatment with a short-acting beta 2 agonist (SABA) alone is no longer the preferred treatment for adults and adolescents with asthma. Subsequently, GINA 2021 has two tracks, one with the preferred approach, using an inhaled corticosteroid (ICS)/formoterol as a single maintenance and reliever therapy (SMART), and a second allowing the more traditional approach using a SABA-based reliever with an ICS or an ICS/long-acting beta 2 agonist (LABA) combination. The GINA 2025 guidelines retain and reinforce the two-track treatment approach while significantly expanding the role of Type 2 biomarkers, particularly blood eosinophils and fractional exhaled nitric oxide (FeNO), in guiding asthma management. While short-acting bronchodilators may provide symptom relief for patients, they remain at risk for severe exacerbations. In late 2020, a similar update was made to the NAEPP guidelines.