Food allergy is a difficult clinical problem for which no disease-modifying therapy currently exists.The daily administration of graded allergen doses through oral immunotherapy (OIT) is one promising experimental approach to the development of a clinically available treatment. Although the concept of oral immunologic tolerance is not new, OIT as a treatment for food allergy is innovative. Over the last few years, several groups of investigators have begun to demonstrate safety and varying degrees of efficacy and immune modulation in uncontrolled pilot studies of OIT. Rigorously designed trials are currently underway and important unanswered questions remain.OIT for food allergy holds promise for patients with food allergy but additional research is necessary before this approach is ready for clinical use.