Background: Asthma is a chronic inflammatory disorder characterized by airway hyperresponsiveness, leading to recurrent episodes of wheezing, chest tightness, and coughing. Peak Expiratory Flow Rate (PEFR) monitoring is a simple, cost-effective method to assess pulmonary function and potentially improve asthma management. Objective: This study aimed to evaluate the utility of home PEFR monitoring in asthma management compared to standard symptom-based management. Methods: A prospective, interventional, case-control study was conducted with 60 asthma patients (30 cases and 30 controls) from a tertiary care institute. The study group performed daily home PEFR monitoring, while the control group received standard asthma education. Pulmonary function tests, exacerbation rates, hospital admissions, and Asthma Control Test (ACT) scores were recorded and analyzed over one year. Results: The study showed significant reductions in PEFR reversibility (from 8.58% to 3.25%, p<0.01), ACT scores (from 20.11 to 21.78, p<0.01), exacerbation rates (from 6.09 to 2.36, p<0.01), and hospital admissions (from 0.54 to 0.27, p=0.034) in the study group compared to the control group. A strong positive correlation was found between pre-bronchodilator FEV1 and PEFR values (r=0.939), and a significant negative correlation between ACT scores and exacerbations (r=-0.831) and admissions (r=-0.742). Conclusion: Home PEFR monitoring, combined with asthma education and a symptom-based action plan, significantly reduces asthma exacerbations and hospital admissions. Regular monitoring and educational interventions are crucial for effective asthma management.