Seasonal allergic rhinitis (SAR) is a common disorder affecting up to 20% of the population ( Scadding et al, 2008 ). Symptoms include nasal irritation, sneezing, itching, rhinorrhoea and nasal blockage, which may be intermittent or persistent. These symptoms may lead to sleep disturbance, which adversely affects quality of life (QOL) and learning ability, and can contribute to a drop in grades in examinations taken in the summer months. An accurate diagnosis and optimal management of SAR is essential to minimise the effects of this common allergic disease on the individual. Allergic rhinitis (AR) is often ignored, misdiagnosed and mistreated. Undertreated AR impairs quality of life, exacerbates asthma and is a major factor in the development of asthma ( Scadding, 2015 ). This clinical case will focus on a teenager with SAR, and the immunological implications and therapeutic management of this disease will be discussed.