Background. Monocyte chemotactic protein 1 (MCP-1) plays an important role in various immune and allergic disorders since it is a potent chemo-attractant for inflammatory cells, such as eosinophils, memory T cells, and monocytes. Objective. To investigate serum MCP-1 during asymptomatic state and acute attacks of bronchial asthma. Methods. In this longitudinal cohort design study, sequential serum levels of MCP-1 were measured by a sandwich enzyme-linked immunosorbent assay (ELISA). Twenty-four asthma patients' MCP-1 levels were examined at 5 time points: during the asymptomatic phase, in an acute wheezing episode, and at 1 week, 1 month, and 2 months after acute asthma attack. Fifteen children without asthma were enrolled as control. Results. During the asymptomatic phase of asthma, serum MCP-1 levels were significantly higher than that of normal controls (329.57 ± 99.20 pg/ml vs. 213.63 ± 77.29 pg/ml, p = 0.001). In comparison with the asymptomatic phase, the serum MCP-1 levels during the acute asthma attack were significantly higher (682.88 ± 88.45 pg/ml vs. 329.57 ± 99.20 pg/ml, p < 0.001). After treatment of acute asthma exacerbation, all of the serum MCP-1 levels declined within 1 week, but were still higher than control 2 months later. Conclusion. In asthma patients, the consistently elevated serum levels of MCP-1 suggest its role in the pathogenesis of bronchial asthma - not only in the chronic inflammatory processes, but also in acute asthma attack exacerbation. These findings suggest a possible role for MCP-1 in the pathogenesis of asthma and a potential role for its use in anti-asthma treatment in the future.