The symptoms of histamine intolerance are similar to those of the IgE-mediated allergic immune response. Patients affected by this disease, mostly middle-aged women, suffer from conditions such as headaches and rhinitis, particularly after consuming histamine-rich foods, indulging in alcoholic beverages, or taking certain pharmaceuticals. Moreover, life-threatening anaphylactic reactions can be observed with this syndrome. This article describes the biochemical processes and cellular background of histamine intolerance syndrome and discusses the diagnostic and therapeutic procedures within otorhinolaryngology. It is our goal to direct attention to this often unrecognized clinical picture and to contribute to increased immunologic knowledge of this disease.