PURPOSE: To investigate the trend in prescribing of inhaled corticosteroids and general practitioner (GP) consultations for respiratory diseases. METHODS: A longitudinal observation study of all prescriptions, from primary care, for inhaled corticosteroids dispensed in Scotland from January 1999 to May 2002 was undertaken. The main outcome measures were the trends in prescribing of inhaled corticosteroids and GP consultations for respiratory diseases. RESULTS AND CONCLUSIONS: The prescribing of all inhaled corticosteroids has risen over the study period. The rise in prescribing of the combination product containing fluticasone and salmeterol appears not to have been at the expense of the prescribing of fluticasone alone while the prescribing of the budesonide/eformoterol combination may be at the expense of budesonide (BUD) alone. GP consultations for both asthma and chronic obstructive pulmonary disease (COPD) have declined over a similar period. The increased prescribing of inhaled corticosteroids over this period is associated with the increased use of the fluticasone/salmeterol combination rather than an increase in the use of all inhaled corticosteroids. The accompanying fall in number of consultations with GPs may be due to this increased prescribing or a move to nurse led clinics.