Acuteexacerbations in asthma patients, particularly those with pre-existing cardiovascular conditions, present significant clinical challenges due to the complex interplay between respiratory and cardiovascular systems. This systematic review evaluates the impact of various respiratory therapy modalities on the incidence and outcomes of these exacerbations, following the PRISMA guidelines for systematic reviews. We conducted a comprehensive analysis of studies focusing on pharmacologic treatments (e.g., bronchodilators, corticosteroids) and advanced non-pharmacologic interventions (e.g., non invasive ventilation, invasive mechanical ventilation, extracorporeal life support). Our review included randomized controlled trials, cohort studies, and narrative reviews to assess the effectiveness of these therapies. Key findings indicate that while non invasive ventilation can reduce intubation rates in severe exacerbations, therapies like extracorporeal life support (ECLS) show promising results in managing refractory cases. However, the evidence remains limited, with a notable gap in high quality studies addressing the management of this complex patient population. Methodologically, studies included in this review varied in design, with several utilizing post-hoc analyses and retrospective data. The review highlights the necessity for large-scale, randomized trials to further investigate these modalities. Ultimately, refining therapeutic approaches for asthma patients with cardiovascular comorbidities could optimize outcomes and reduce mortality associated with acute exacerbations.