Allergen specific immunotherapy (SIT) is the only potentially curative treatment of IgE mediated allergic diseases. To ensure its effective use, many requirements must be met before and during therapy. Before starting immunotherapy, informed consent should be obtained, along with the consideration of the indications and contraindications. SIT should be prescribed and administered only by physicians with experience in allergic disease who are qualified to manage severe anaphylactic reactions. The clinical symptoms and the age of the patients determine the route of application, choice of allergen extracts and the duration of treatment. Numerous products and protocols facilitate an individualised therapy.