A 34-year-old member from the United States experienced a severe asthma attack following her successful summit of Mount Kilimanjaro. The combination of extreme altitude and exertion triggered shortness of breath and chest tightness, which worsened during descent to Kosovo Camp. At that elevation, the risk of altitude-related illness such as high-altitude pulmonary edema increased. Given her deteriorating respiratory status and the absence of high-level care at the camp, Global Rescue approved a helicopter evacuation. She was airlifted to a nearby hospital where she was treated for both asthma and HAPE. Her oxygen levels stabilized following supportive care and medication. She was discharged in improved condition and no longer required further medical assistance. The case highlights the dangers of underlying respiratory conditions at altitude and the necessity of rapid intervention.