Severe asthma is a complex, heterogeneous disease that remains a major therapeutic challenge. Despite several biologics targeting type 2 (T2) inflammation, some patients remain uncontrolled, highlighting the need for upstream interventions. Tezepelumab, a monoclonal antibody against thymic stromal lymphopoietin (TSLP), has shown broad efficacy in randomized trials regardless of eosinophilic status or biomarker levels. We conducted a prospective, multicenter, observational study to assess real-world effectiveness and safety of tezepelumab in severe asthma.