<p>Family dynamics, including caregiver-adolescent relationships, are an important predictor of adolescent health. Little is known about how perceptions of conflict between caregivers and adolescents, and discrepancies in those perceptions, are related to adolescent asthma outcomes. This study examined associations between both caregiver and adolescent perceptions of caregiver-adolescent conflict, as well as discrepancies in perceptions, and adolescent asthma outcomes (quality of life [QOL], asthma control, emergency department [ED] visits). Sixty-one adolescents (54.1% female; 93.4% Black or African American) and their primary caregivers (90.2% mothers) living in an urban area both completed questionnaires either in a research office or at the family’s home. Adolescent and caregiver reports of relationship conflict were correlated; on average adolescents endorsed less perceptions of conflict than caregivers. Adolescent reports were significantly associated with QOL and asthma control, whereas caregiver reports were significantly associated with ED visits. Discrepancy scores between caregiver and adolescent reports of conflict among each dyad was a significant predictor of QOL, but not asthma control or ED visits. Overall, findings suggest that evaluation of relationship quality from both caregivers and adolescents are important to assess, as they may be associated with different adolescent wellbeing and health-related outcomes. Further, the agreement/disagreement on conflict perceptions between adolescents and caregivers may be central to adolescent’s overall wellbeing; however, this should be explored further. Future research should continue including reports from both adolescents and caregivers and consider investigating strength-based approaches for promoting family relationships and communication in order to improve asthma outcomes among adolescents.</p>