Anaphylaxis is an acute, potentially life-threatening systemic allergic reaction that may have a wide range of clinical manifestations. The lifetime prevalence of anaphylaxis has been estimated at 1.6% to 5.1%. Medications and stinging insects are the leading triggers in adults, with foods and stinging insects the most frequently implicated triggers in children and adolescents. Food allergy impacts 8% to 11% of children and adults in the United States. IgE binding and cross-linking of the high affinity IgE receptor (FcεRI) on the surface of mast cells and basophils is an important mechanism in many cases of anaphylaxis. Anaphylaxis involves additional cell types that may include neutrophils, monocytes, macrophages, and platelets. Epinephrine administered intramuscularly into the anterolateral thigh as the first-line treatment for anaphylaxis. Epinephrine is the cornerstone of anaphylaxis management but continues to be underutilized. Antihistamines and/or glucocorticoids are not reliable interventions to prevent biphasic anaphylaxis. This session will work through case-based scenarios of allergy emergencies and anaphylaxis. Elements of the patient’s history and physical exam findings will be used to determine the diagnosis. Treatment strategies will be discussed, with particular attention to allergy emergencies encountered in the clinical setting. The presenters will lead the participants through the Anaphylaxis— A 2020 Practice Parameter Update, Systematic Review, and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) analysis by working through several real world scenarios. This small group session will feature interactive teaching and learning strategies. We will work though several cases including an episode of anaphylaxis triggered from allergy testing. It is important that otolaryngologists offering allergy services be competent in the management of anaphylaxis.