The effects and clinical management of patients with respiratory disease that are exposed to indoor mold colonization are still not fully understood. A recent effort by a Working Group of the American Academy of Allergy compiled six peer-reviewed papers covering responses to fungal products and health effects related to exposure and clinical management. Recent information on the innate immune system and the interaction with various microbial components sheds light on the prevailing controversy of whether health effects associated with damp buildings are due to mycotoxins or allergens. Other microbial products are now seen as likely factors to these respiratory effects.