Purpose of review: Purpose of review IgE-mediated food allergy (FA) is a potentially life-threatening condition with negative impact on the quality of life of patients and their family. It has been emerging as a public health priority in westernized countries in the recent two decades. The current standard approach to FA consists of the strict avoidance of the triggering food and keeping rescue medication readily available in the event an allergic reaction occurs. However, an elimination diet may be difficult and frustrating, above all for those foods (e.g., milk and egg) that are pivotal in the common diet. Recent findings: Recent findings Oral immunotherapy (OIT) may increase the amount of food that the patient can intake without reaction, and reduce the risk of potential life-threatening allergic reactions As its enormous potential, OIT is currently considered the most promising treatment for FA. However, many gaps are still unsolved. OIT is logistically demanding, time-consuming, and most patients are affected by side effects though often mild. Summary: Summary The aim of this review is to shed light on the main needs in OIT that are currently unmet in order to stimulate in the near future the development of longitudinal, prospective, well-designed studies with the final goal of a “precision medicine”, tailored on each single patient suffering from FA. © 2017, Springer International Publishing AG.