Objective - This article presents hospitalization and mortality rates for asthma and COPD in Réunion and the French West Indies and compares them with those in mainland France. Methods - The analysis covered hospital stays (PMSI) and deaths (CépiDc) occurring between 2005 and 2007. The analyses were conducted among individuals aged 2 years or older, as asthma is difficult to diagnose before this age. Results - In 2005–2007, hospitalization rates for asthma were higher in the French overseas departments than in mainland France. The highest rates were observed in the Antilles for those aged 2–44 and in Réunion for adults aged 45 and older. Compared to mainland France, hospitalization rates for COPD were higher in Réunion and lower in the Antilles. Mortality data were consistent with hospitalization data. However, the small sample sizes did not allow for an analysis of regional disparities in mortality among people under 45 years of age. Conclusion - Hospitalization rates for asthma are high in the overseas departments, reflecting both a higher prevalence and poorer disease control. Efforts must be made to improve the management of people with asthma in the overseas departments. (R.A.)