Allergic disease represents an increasing problem in industrialized countries. However, allergy diagnosis and specific immunotherapy, the only curative approach towards the treatment of IgE-mediated disorders, are still performed like in their very beginnings more than a century ago. The use of allergen extracts of undefined contents bears the risk of anaphylactic side effects and sensitization to new allergens during immunotherapy. This review focuses on production, physicochemical, and immunological requirements, as well as on the multiple advantages of recombinant allergens and hypoallergens in comparison to conventional allergen extracts used in allergy diagnosis and therapy. Recombinant allergens offer the perspective of molecule-based allergy diagnosis and consequently safe and patient-tailored immunotherapy.