The crucial position of IgE within the pathogenesis of allergic diseases made it a key target for therapy. The inhibition of the allergic inlammatory cascade by anti-immunoglobulin E (IgE) therapy is a new and promising concept in the treatment of these diseases. Currently available anti-IgE agent omalizumab has been started to be used in past 3 years in the cases of chronic spontaneous urticaria (CSU) and chronic inducible urticaria (CINDU), resistant to the irst-, second-, and some third-line treatments. The use of omalizumab as an efective and safe biological therapy for inadequately controlled severe, persistent patients with CSU and CINDU provided a valuable new treatment option for these patients. However, the data about possible mechanisms of anti-IgE therapy in these patients, treatment strategies and dose regimens of anti-IgE therapy are diferent, and special patient groups and possible side efects are still insuicient. Also, studies about possible future anti-IgE treatment options are ongoing in CSU.