Itch is the cardinal symptom of scabies, present in more than 90% of the cases, generalized and intense, worsening at night, and often sparing the head. The primary complications of the itch in scabies are secondary bacterial infections and psychosocial issues leading to impairment on life quality. Currently, there are no specific data analyzing mechanisms of the itch in scabies, but the latest progress made in the understanding of host-mite interactions may help to improve understanding. Management of itch in scabies consists primarily of the treatment of the mite infestation, but sometimes the itching sensation may persist after adequate therapy.