Since the publication of the first edition in 2000, the Japanese Pediatric Guideline for the Treatment and Management of Asthma (JPGL) has provided standard treatment and management guidelines, contributing to improved clinical care. JPGL2023, following methodology adopted from "Minds Clinical Practice Guidelines", conducted systematic reviews of 14 Clinical Questions (CQs) and revised the associated guidelines to align clinical practices with evidence-based medicine (EBM). Chapter 12 presents remaining challenges towards the establishment of better guidelines. Development of high-quality evidence specifically focused on the Japanese pediatric population is of particular importance. Critical priorities include the establishment of prevention strategies, understanding infant wheezing pathophysiology, optimization of its treatment, and development of long-term outcome assessment and therapeutic strategies for adolescent asthma. It is also necessary to clarify the appropriate positioning of new therapeutic options, including allergen immunotherapy, biological agents, maintenance and reliever therapy, and high-flow nasal cannula oxygen therapy. Promoting standardized treatment and equalizing medical care based on the Basic Act on Allergic Disease Measures as well as developing research promotion systems also remain crucial challenges. Systematic efforts are required to address these challenges.