Background: Omalizumab, an anti-IgE antibody, is used to treat patients with severe allergic asthma. The evolution of lung function parameters over time and the difference between omalizumab responder and nonresponder patients remain inconclusive. The objective of this real-life study was to compare the changes in forced expiratory volume in 1 s (FEV1) of omalizumab responders and nonresponders at 6 mo. Methods: A multicenter anal. was performed in 10 secondary and tertiary institutions. Lung function parameters (forced vital capacity (FVC), pre- and postbronchodilator FEV1, residual volume (RV), and total lung capacity (TLC)) were determined at baseline and at 6 mo. Omalizumab response was assessed at the 6-mo visit. In the omalizumab responder patients, lung function parameters were also obtained at 12, 18, and 24 mo. Results: Mean prebronchodilator FEV1 showed improvement in responders at 6 mo, while a decrease was observed in nonresponders (+0.2±0.4 L and -0.1±0.4 L, resp., P<.01). After an improvement at 6 mo, pre- and postbronchodilator FEV1 remained stable at 12, 18, and 24 mo. The FEV1/FVC remained unchanged over time, but the proportion of patients with an FEV1/FVC ratio <0.7 decreased at 6, 12, 18, and 24 mo (55.2%, 54.0%, 54.0%, and 44.8%, resp., P<.05). Mean RV values decreased at 6 mo but increased at 12 mo and 24 mo (P<.05). Residual volume/total lung capacity (RV/TLC) ratio decreased at 6 mo and remained unchanged at 24 mo. Conclusion: After omalizumab initiation, FEV1 improved at 6 mo in responder patients and then remained stable for 2 years. RV and RV/TLC improved at 6 mo.