Insect sting allergy has served as an excellent model for the allergic process over the past century. In particular, during the last 30 years, a new form of diagnostic testing and treatment with vo m has been one of the great suc-cess stories in the entire field of allergy. VIT reduces the risk of recurrent life-threatening reactions from about 60% to less than 2%. Progress and further questions continue with a search for a definitive diagnostic test that more accurately predicts which patients are at risk for future reactions, and defines which patients can stop VIT and which ones need to continue treatment.