The aim of this study was to investigate the relationship between urinary eosinophil protein X (uEPX) and asthma symptoms, lung function, and other markers of eosinophilic airway inflammation in asthmatic school children. Methods. A cross-sectional study was performed in 180 steroid dependent atopic children with stable moderately severe asthma, who were stable on 200 or 500μg of fluticasone per day. uEPX was measured in a single sample of urine and was normalized for creatinine concentration (uEPX/c). Symptom scores were kept on a diary card. FEV1and PD20methacholine were measured. Sputum induction was performed in 49 and FENOlevels measured in 24 children. Results. We found an inverse correlation between uEPX/c and FEV1(r=-.20, P=.01) and a borderline significant correlation between uEPX/c and PD20methacholine (r=-.15, P=.06). Symptom score, %eosinophils and ECP in induced sputum and FENOlevels did not correlate with uEPX/c. Conclusion. uEPX/c levels did not correlate with established markers of asthma severity and eosinophilic airway inflammation in atopic asthmatic children. Copyright