Severe allergic asthma is a heterogeneous and burdensome condition characterized by persistent airway inflammation, heightened sensitivity to allergens, and frequent exacerbations that impair quality of life. Emerging evidence highlights the importance of early intervention in altering disease progression, reducing exacerbation risk, and preventing irreversible airway remodeling. This presentation will review the underlying immunopathology, including IgE-mediated responses and eosinophilic inflammation, and emphasize the role of early diagnosis and risk stratification through clinical assessment, lung function testing, and biomarkers. Optimal therapy strategies will be discussed, focusing on inhaled corticosteroids/long-acting bronchodilators and the integration of biologics targeting IgE, IL-5, and IL-4/IL-13 pathways within a precision medicine framework. Finally, future perspectives on multidisciplinary care and patient-centered approaches will be outlined. By combining timely intervention with tailored therapy, clinicians can significantly improve outcomes and reduce the overall burden of severe allergic asthma.