ABSTRACT: Background: Although there is a great deal of conversation on social media, there may not be good communication. Objective: We sought to investigate communicaton activity online by examining digital footprints (or "sociomes") of asthma stakeholders on Twitter. Methods: Tweets containing the word "asthma" and the hashtag #asthma were collected using Symplur Signals. Characteristics of usage and tweets were analyzed and compared first between the word "asthma" and the hashtag #asthma, and then among four different stakeholder groups: clinicians, patients, healthcare organizations, and industry. Results: The #asthma sociome was significantly smaller than the "asthma" sociome, with fewer users and tweets per month. However, the #asthma sociome correlated better to asthma seasons and was less susceptible to vulgarity and viral memes. For the #asthma sociome, there were 695,980 tweets by 308,370 users between April 2015 and November 2018. Clinicians were responsible for 16% of tweets, patients 9%, healthcare organizations 22%, and industry 0.3%. There were significant differences in the tweet characteristics, with healthcare organizations more likely to tweet with links, clinicians more likely to mention other users, and industry more likely to use visuals. Each April-May, there were significant spikes in the frequency of tweets by patients, healthcare organizations, and industry, whereas the usage patterns of clinicians were more random. There were also differences in the top terms and hashtags tweeted with #asthma in the stakeholder groups. Conclusion: Asthma stakeholder groups tweet differently, at different times, and use different associated terms. Further exploration may help improve health care-related communication and help guide education of patients and clinicians.