Local allergic rhinitis (LAR) describes a condition in which a patient has clear symptoms suggestive of allergic rhinitis and has a nasal eosinophilic inflammation with local specific IgE to a specific allergen but is negative on testing for systemic atopy. A considerable number of cases with rhinitis, in which SPT is negative and sIgE is undetectable, do in fact produce a positive response to the nasal allergen challenge (NAC). This phenotypical manifestation of AR is known as LAR. LAR affects the entire age range from children to adults, across the world, and symptoms may range from mild to severe. Despite the negative effects of LAR on patients’ quality of life and the way symptoms may quickly deteriorate, it is generally underdiagnosed. LAR persists as a condition in its own right. It is not merely a precursor to systemic AR. There are many common elements between AR and LAR, such as positive NAC, the presence of features indicating a type 2 inflammatory response in the nose (e.g. sIgE in secretions from the nose) and an increased risk of becoming asthmatic. In this chapter, we reviewed LAR in all aspects.