This study provides an overview of the consequence of the use of oral corticosteroid in the treatment of severe asthma in adults; it also identified recent evidence based alternative drug regimen for asthma management to prevent long term negative effect of oral corticosteroids. Asthma is a chronic inflammatory airway disease affecting about 300 million people globally. Approximately 4% to 8% of asthma patient’s symptoms remain uncontrolled and exacerbations occur frequently despite high-intensity treatment, hence the need for corticosteroid treatment for sustain symptom control and to prevent flare-ups. Oral corticosteroids are powerful anti-inflammatory medicine which helps by quickly reducing the swelling in the lungs. There is no doubt that the use of oral corticosteroids (OCS) plays a vital role in the management of asthma, particularly in the management of acute exacerbations and severe asthma. However, there is clinical evidence that both long- and short-term use of corticosteroids in asthma has complicated relationship with some referring to them as a ‘frenemy, as side effect of oral corticosteroids has detrimental effect on quality of life of asthma patients. The study utilized literature review of web-based articles and journals using multiple databases. Studies both on short term and long- term use of OCS was reviewed to have better understanding of the subject matter. Studies in children populations were excluded as the focus of this study is on adult patients living with asthma. Following the literature search, ten articles met the inclusion criteria and were selected. The study concluded that due to widely acknowledged side effects, and advances in care, there is clinical support for a shift away from a reliance on OCS in the treatment of severe asthma to other alternative management.