Oral corticosteroids are first-line therapy for allergic bronchopulmonary aspergillosis (ABPA), however, itraconazole has been recognized as an adjunctive treatment. This paper describes the prolonged use of itraconazole in an asthmatic patient with a diagnosis of ABPA. This case report features a patient who showed benefit with a longer duration of itraconazole therapy without demonstrating adverse events related to treatment over nearly eight years. Prolonged treatment with itraconazole may serve as a corticosteroid sparing option for ABPA patients.