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Airway mucus plugs occur frequently in participants in the Severe Asthma Research Program (SARP) cohort, and “mucus plug-high” asthma is characterized by severe airflow obstruction. We hypothesize that mucus plugs are mechanistically linked to airflow obstruction and air trapping via direct occlusion of airways, and that the location of mucus-occluded airways determines the severity of obstruction and trapping. Thoracic radiologists performed detailed annotations of airways completely occluded with mucus in chest computed tomography (CT) scans from 55 patients in the SARP cohort. From these annotations we generated pixelwise segmentation information for each plug. Mucus plugs were coregistered with the airway tree to generate a patient-specific mucus plug map for each scan. Mucus plug location was used to generate two novel imaging metrics related to airway resistance and air …