Allergic rhinitis is an increasing burden for our society from the patients point of perspective as well as from the economics perspective. For the treatment the approach has to be separated into disease modifying and non-modifying. Disease modifying Immunotherapy and its basic concept is known for more than 100 years and offers the only way to lower the risk of future development of asthma. Subcutaneous immunotherapy (SCIT) is already well established, but in the last couple decades the research lead to an alternative sublingual immunotherapy (SLIT). Ongoing research in order to improve the safety and efficacy of immunotherapy, as well as to improve convenience and tolerance for patients, lead to tablet based SLIT and shorter course SCIT alternatives and many more approaches. This continuous research is a necessity and promises a much faster evolving immunotherapy then it did in the past.