Introduction This study investigated the use of eucapnic voluntary hyperpnea (EVH) to monitor efficacy of pharmacological therapy in elite swimmers with exercise‐induced bronchoconstriction (EIB). Secondly, it evaluated the long‐term test‐retest repeatability of EVH in this population. Methods Twenty‐seven elite international swimmers were included in this retrospective analysis of comprehensive respiratory assessments. Following an initial “withheld‐therapy” assessment, athletes with EIB had been prescribed appropriate pharmacological therapy and returned twelve months later for a follow‐up assessment to monitor EIB protection afforded by treatment. EIB‐negative athletes had returned to confirm initial diagnosis, as were still reporting persistent respiratory symptoms. Athletes were retrospectively grouped into either “Therapy Adherent Group” (n = 12) or “Repeatability Group” (discontinued therapy at follow‐up or EIB‐negative, n = 15). Results Greatest fall in forced expiratory volume in 1 second (ΔFEV1max) was significantly lower following therapy adherence (−11.8 ± 3.8%) compared to initial assessment (−24.0 ± 11.3%; P < .01). “Repeatability Group” ΔFEV1max did not differ significantly between initial assessment (−13.1 ± 4.5%) and follow‐up (−12.3 ± 5.6%; P = .32), and showed good agreement (0.6%; −5.9%, 7.1%). Conclusion A follow‐up assessment utilizing EVH is useful in the management of EIB and shows good test‐retest repeatability over twelve months in elite swimmers who discontinue treatment or are EIB‐negative.

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