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An update on allergic emergencies. PURPOSE OF REVIEW: To provide an updated framework of management for allergic emergencies. RECENT FINDINGS: The most frequent causes of anaphylaxis include medications, foods, and stinging insects. Early and appropriate administration of epinephrine is critical to managing anaphylaxis. Although epinephrine is well tolerated and there is no absolute contraindication to using epinephrine in first-aid management of anaphylaxis, many patients at risk for anaphylaxis still fail to carry and use the medication prior to seeking emergency care. Outcomes of allergic emergencies can be improved by educational efforts that focus on adherence to emergency plans, as well as asthma controller treatments in patients with persistent asthma. Though venom immunotherapy is known to decrease the risk for stinging insect anaphylaxis, the role of emerging strategies for food allergen immunotherapy in reducing cases of anaphylaxis requires further study. SUMMARY: Fatalities resulting from anaphylaxis and asthma are rare. Patient education serves an important role in preparing for unexpected emergencies, instituting prompt and appropriate treatment, and incorporating effective strategies into the lives of children and families.