It is well known that approximately 30 to 50% of young children experience wheezing until the age of 3, due to the anatomical and physiological characteristics of their respiratory system. However, about half of these children outgrow wheezing by school age. In contrast, most school-age children diagnosed with asthma begin experiencing asthma symptoms before the age of 3. Therefore, the preschool period represents a crucial time window that influences the long-term prognosis of childhood asthma. However, obtaining objective measures of lung function and airway inflammation in young children is challenging. Additionally, diagnosing asthma using conventional criteria and managing it with guideline-recommended treatments is more difficult in younger children with recurrent wheezing compared to school-age children. This paper reviews recent advances in clinical practice for managing asthma/recurrent wheezing, focusing on new approaches to understanding the underlying pathology of asthma in preschool-aged children.