Allergen immunotherapy is a procedure that involves administration of an allergen on a regular basis with the intention to promote specific immune mechanisms and ultimately promote clinical tolerance to the allergen. For foods, several methods of immunotherapy have been studied including oral, sublingual, epicutaneous (patch), and subcutaneous. Subcutaneous immunotherapy for peanut has proven impractical due to risk of developing systemic allergic reaction.71 Out of all methods, OIT for nuts may be the most promising. A number of exciting studies are emerging, though long-term outcomes need to be further evaluated before this therapy is readily accepted for clinical practice. Furthermore, questions remain unanswered regarding whether protocols promote desensitization or tolerance. Desensitization is a temporary and reversible state, meaning once administration of the allergen is suspended, clinical reactivity returns. Tolerance refers to a long-term effect of unresponsiveness to the allergen.