Allergic rhinitis (AR) effects 23-30 % of the European population with equal prevalence in Belgium. Despite guidelines on the correct use of effective treatment, up to 40 % of AR patients remain uncontrolled. Allergen immunotherapy (AIT) has been shown to improve the level of control up to 84 % of patients being controlled by AIT. Recently, new guidelines for AIT have been publised, supporting the clinical evidence for effectiveness of various subcutaneous and sublingual products for AIT in patients who are allergic to airbone allergens. AIT in AR patients only reduces nasal and/or ocular symptoms but also induces tolerance and has preventive potential. Adoption of AIT into daily clinical practice in Belgium and other European countries is hampered primarly by reimbursement issues of each of the single products but also by several patient- and physician-related factors. Patients need tobe better informed about the effectiveness of AIT and the different rotes of administration of AIT. Physicians dealing with AR paitents should inform patients on tolerance-inducing effects of AIT and are in the need of harmonized and practival guidde that supports them in selecting eligible patients for AIT, in choosing evidence-based AIT products and in following treatment protocols with proven efficacy. Therefore, a stepwise and holistic approach is needed for better adoption of AIT in the real-life setting in Belgium.