Reslizumab, an anti-interleukin-5 (anti-IL-5) monoclonal antibody, is indicated as add-on maintenance treatment for adults with severe eosinophilic asthma.This retrospective study examined real-world outcomes associated with reslizumab use in patients with severe eosinophilic asthma in US clinical practice.Patient-level data from adults treated with reslizumab were obtained from center- and panel-based medical chart reviews. Eligible patients had available medical records and treatment history for ≥ 6 months pre-reslizumab treatment initiation (index date) to ≥ 7 months post-reslizumab initiation. The primary outcome was response to reslizumab treatment, based on clinical expert pre-defined definitions of response. Other outcomes included clinical asthma exacerbations (CAE), use of maintenance oral corticosteroids (OCS), forced expiratory volume in 1 second (FEV1) percent predicted, Asthma Control Test (ACT) score, and healthcare resource utilization (HRU).Medical charts were obtained for 215 patients. Most patients (58.6%) had excellent response, 16.3% had clinically meaningful response, 21.9% had partial response, and 3.3% were non-responders/treatment failures. There was a significant reduction in the proportion of patients experiencing a CAE in a 6-month period (from 86.0% to 40.5%; P < .001), and the mean [SD] number of CAEs per patient (2.84 [2.41] vs 0.94 [1.86]) post-reslizumab initiation. Improvements were observed in FEV1 percent predicted (65.1% [20.5%] vs 73.1% [23.1%]; P < .001), and ACT scores (13.8 [4.2] vs 18.6 [4.0]; P < .001) pre- to post-reslizumab initiation. Among patients using maintenance OCS at baseline, more than half discontinued use of these by approximately 10 months post-reslizumab initiation. Significant reductions in asthma-related HRU were observed post-reslizumab initiation.In clinical practice, reslizumab may have been initiated in response to heavy symptom burden and CAEs. Reslizumab was associated with improved clinical and patient-reported outcomes and significant reductions in asthma-related HRU.