Education and prevention are the most important aspects of the management of anaphylaxis, the most deadly of all allergic diseases. Although anaphylactic reactions are rarely anticipated and are unavoidable in the practice of medicine, general and specific preventive measures can decrease the incidence and severity of the reactions.In patients predisposed to anaphylactic episodes, a thorough history for the identification of precipitants, supplemented by serum IgE- specific testing (RAST and immune CAP) or skin tests is necessary. Whenever possible, if the history suggests a reaction to a specific agent, a substitute, non- crossreactive one should be administered. Oral administration of drugs is less probable to produce a severe reaction than the parenteral route. Every patient should remain a minimum of 20-30 minutes in office if receives an injection, and 2 hours if the drug is administered orally for the first time. Patients who have experienced an anaphylactic reaction are at greatest risk to suffer another episode. Such individuals should wear a Medic- Alert bracelet and should keep an identification card in their wallet or purse. Such patients and their families should be instructed to carry an autoinjectable epinephrine (EpiPen) and renew the prescription when the expiration date is reached. In addition, they should have an individualized action plan. Avoidance of b-blockers, ACE inhibitors and MAO inhibitors is recommended. Prophylactic use of corticosteroids and H1& H2 receptor antihistamines may be beneficial in recurrent idiopathic anaphylaxis.Avoidance of the provocative agent (food, antibiotic, aspirin, latex …), desensitization (when an antibiotic critically needed), immunotherapy (insect venom), pretreatment (radiocontrast media) and laboratory tests (skin tests, RAST …) are different therapeutic and diagnostic considerations for prophylaxis of specific anaphylactic syndromes. Therefore prevention and education are of paramount importance in the management of the patient at risk for anaphylaxis.