Theophylline, also known as dimethyl xanthine, has been utilized for over 80 years to treat airway diseases. Initially used as a bronchodilator, its usage declined due to side effects associated with relatively high doses. Recent studies have demonstrated theophylline's effects that reduce inflammation in conditions such as asthmas well as long term obstructive lung disease at low level of concentration. The mechanism include: Inhibition of PDE3 for bronchodilator and suppression of PDE4, along with enhances histone deacetylase -2 (HDAC 2), as a result the suppression of genes involved in inflammation that are activated. Theophylline can reverse resistance to corticosteroids, particularly in chronic asthma as well as COPD, where activity of histone deacetylase -2 (HDAC 2) has decreased. Theophylline has provided by systemic administration, either taken orally as a long-term remedy or administered intravenously for severe asthma. Blood concentrations and effectiveness are related, primarily influenced by metabolism in the liver that can be altered by various diseases and concomitant drug therapies. Typically used as additional form of therapy for patients with chronic lung disease not adequately regulated when using long-acting ?2-agonists in conjunction using corticosteroids that are inhaled. Also used in patients with long-term obstructive lung disease along with a severe disease that cannot be controlled with bronchodilator medication. The adverse consequences are concentration-dependent and consist of headache, nausea, as well as vomiting at lower concentrations because of a blockage of phosphodiesterase. In greater concentration, side effects may include irregularities of heartbeat and seizures because of adenosine A1receptor antagonism. At low doses of theophylline can hold promise in the future for lowering the resistance to corticosteroids in long-term obstructive lung disease and asthma. This summary highlights the dual role of theophylline serving to be anti-inflammatory as well as bronchodilator, with potential implications for the management of severe respiratory conditions. This study clarifies the mechanism of action of theophylline and investigates its synthesis. Theophylline, a common bronchodilator, is produced in large part thanks to the effective synthesis technique that is being presented. Our comprehension of the drug's pharmacological properties is improved by the clarification of its mechanism of action, which provides future developments in its therapeutic uses.