Recent research has elucidated many of the immunologic mechanisms that underlie atopic allergies. In particular, it has become clear that the role of CD4+ allergen-specific T cells is crucial for the induction of IgE and eosinophilia, factors that mediate the immediate hypersensitivity reaction and late-phase responses, respectively. Therefore, the reactivity patterns and activation requirements of allergen-specific T cells are important parameters for understanding and manipulating the allergic immune response. This review addresses these issues and discusses their relevance to the further development of allergy vaccines.