Peanut allergy raises major concerns and requires diligence in families because of the possibility of severe reactions, the perceived inability to outgrow peanut allergy, and the widespread availability of peanuts in the Western diet. However, studies in the past year have shown that a subset of patients with peanut allergy can become tolerant to peanut. The patients with the milder reactions on presentation have a better chance to develop tolerance to peanuts than the patients whose first reaction is anaphylaxis. This review will focus on the mechanism of allergic sensitization to peanuts and the natural history of peanut allergy as it is currently evolving. The effects of cooking and altering peanut allergens are discussed as are potential treatment modalities.