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Because \u226540 deaths per year are attributed to insect stings, it is critical that healthcare providers and the public understand the proper diagnosis as well as the long\u2010term treatment of this potentially life\u2010threatening allergy. Unlike food and medication allergy, which are managed primarily by allergen avoidance, Hymenoptera allergy is managed prospectively using venom immunotherapy; this results in a protective level of up to 98%. Insects of the order Hymenoptera include bees, wasps, hornets, yellowjackets, and ants. They are responsible for the majority of the fatal and near\u2010fatal sting events. Understanding the biology and habitat of the various Hymenoptera species is helpful in recommending insect\u2010avoidance strategies. The diagnosis of insect allergy relies on a history of a systemic allergic reaction with appropriate testing for venom\u2010specific immunoglobulin E. If the history of a systemic reaction to an insect sting and the presence of venom specific immunoglobulin E is confirmed, venom immunotherapy is indicated. The proper and primary means of treating acute anaphylaxis is immediate epinephrine\u2014and studies suggest that it is underutilized in the acute setting. However, it is venom immunotherapy, a disease\u2010modifying therapy, that provides the affected individual with the most effective protection against future sting reactions. Long\u2010term management of insect allergy and anaphylaxis includes appropriate referral to an allergist familiar with insect allergy and, if indicated, venom immunotherapy. <jats:bold><jats:italic>Mt Sinai J Med 78:773\u2013783, 2011.<\/jats:italic><\/jats:bold> <jats:italic>\u00a9 2011 Mount Sinai School of Medicine<\/jats:italic><\/jats:p>","DOI":"10.1002\/msj.20286","type":"journal-article","created":{"date-parts":[[2011,9,12]],"date-time":"2011-09-12T23:05:30Z","timestamp":1315868730000},"page":"773-783","source":"Crossref","is-referenced-by-count":18,"title":["Insect Allergy"],"prefix":"10.1002","volume":"78","author":[{"given":"James M.","family":"Tracy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2011,9,12]]},"reference":[{"key":"e_1_2_9_2_2","doi-asserted-by":"crossref","unstructured":"SimonsFE.Anaphylaxis.J Allergy Clin Immunol2008; 121(2 suppl):S402\u2013S407.","DOI":"10.1016\/j.jaci.2007.08.061"},{"key":"e_1_2_9_3_2","doi-asserted-by":"crossref","unstructured":"SimonsFE FrewAJ AnsoteguiIJ et al. 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