Explanatory models (EMs) were collected from 20 African-American adult primary caregivers, in Seattle and New Orleans, who have children with asthma, to understand asthma from their perspective. Family EMs of asthma shed light on the meaning family members give to the illness, and how they make internally logical decisions related to their healthcare behavior. Study findings show that families have their own EMs of asthma. Families draw on their cultural context to understand asthma. They compare their lived experience with healthcare-provider explanations of asthma. Specifically, the African-American families in this study drew much of their information about asthma from other family members and from personal experience. Collecting EMs of asthma may help healthcare providers know the meaning of asthma as understood by specific families and may reduce unscheduled use of health services. Further research should include encounters which increase the healthcare provider's context for understanding patient and family EMs.