Objective: We reexamined asthma prevalence in urban public elementary school children after 12 years, during which time poverty had worsened. Study design: We surveyed 152 children in 1992 and 331 in 2004 attending fourth- and fifth-grade classrooms in a low-income area of St. Louis, Missouri. Prevalences of phenotypes (current asthma, previous diagnosis without current asthma, and frequent wheezing without diagnosis) were based on standard published questions. We assessed age, sex, percentage below poverty level, and asthma experience (household member with asthma; friend, relative, or neighbor with asthma; or ever having seen someone have an attack). Results: Prevalences were similar in 1992 and 2004 for current asthma (18% and 20%) and frequent wheezing without diagnosis (24% and 26%), despite higher 2004 percentage below poverty level (40% vs 18%). Prevalences of phenotypes were not associated with demographics or percentage below poverty level but were associated with asthma experience. In multivariate analysis, current asthma was associated with household member with asthma and ever having seen someone have an attack, and previous diagnosis was associated with household member with asthma. Conclusions: For these fourth- and fifth-grade urban public school children, self-reported asthma prevalence was similar after 12 years despite worsening poverty.