The relationship of alcohol intake and urticaria is complex. The mechanism of action may be related to a hypersensitivity reaction to ethyl alcohol or to the other components of alcoholic drinks. Urticaria may also result from the pharmacological effects of alcohol or from the histamine content of the drink. The authors review the literature about hypersensitivity to alcohol and to the different components of alcoholic drinks, especially added compounds. The appropriate sensitivity tests for making this diagnosis are described.