Allergic rhinitis is a common and increasingly prevalent disease worldwide, affecting at least 10-25% of the population. Although allergic rhinitis is not a life-threatening disease, it can have significant adverse effects on performance, mood, and sleep, as well as on other comorbid medical conditions. The number of agents available to treat allergic rhinitis has expanded beyond first-generation antihistamines, although there is still widespread OTC use of these products. The current and impending OTC availability of second and third generation antihistamines, the development of newer prescription agents with different physiological approaches, and the emerging availability of immunotherapy, have broadened the treatment options among which clinicians and patients can choose. How these issues impact the type of patient presenting to physicians, the types of therapy they may have already tried, and the degree of counseling or further medical evaluation needed represents a shift in the treatment paradigm of allergic rhinitis, and thus an important area of discussion among allergists.