Chronic urticaria (CU) is a debilitating skin disease characterized by intensely itchy wheals, angioedema, or both for longer than 6 weeks.1 The Urticaria Control Test (UCT) is a validated patient-reported out come measure (PROM) to assess disease control in CU2 over a recall period of 4 weeks. UCT includes four questions, related to physical symptoms (Q1), quality of life (Q2), treatment effect (Q3), and overall control (Q4) with five answer options each (scored 0–4 points), with a total score ranging from zero to 16.2 UCT validity was demonstrated in clinical trial settings,3,4 but real-world data are largely missing. Thus, UCT scale validity and reli ability should be confirmed in a real-world population, to inform and direct further use and support better clinical decision-making and patients' outcomes.5 To this end, we analyzed (SPSS; version 28.0) fully anonymized UCT data of 1357 CU patients at the Urticaria Center of Excellence and Reference (UCARE)-Berlin. Three methods were used to assess the structural validity of the scale: First, items (UCT questions), and sets of items were correlated with the total UCT score using the Spearman correlation, and Cronbachs alpha was calculated to assess consistency. Second, a stepwise multiple regression analysis, taking the UCT score as a dependent variable, was run with items as indepen dent variables; r-squares assessed model fit. Third, a factor analysis using the principal component method re-explored the dimensional ity of the items versus CU control concept, identifying whether items measure the same underlying construct (control of CU) and which items are most strongly related to it (Supplementary Material).