Jason Hawkes, MD, MS, FAAD, and Kristin Sokol, MD, MS, MPH, delivered a comprehensive review of chronic spontaneous urticaria (CSU), covering everything a dermatology provider needs to know—from diagnosis to emerging treatments. They defined CSU as chronic urticaria lasting more than six weeks, without an identifiable trigger, and characterized by wheals that typically resolve within 24 hours. The speakers discussed the latest clinical efficacy data on new and emerging CSU therapies, offered strategies for managing associated safety concerns, and provided guidance on personalizing treatment plans. The presentation reviewed the stepwise treatment approach to CSU developed as a joint initiative from allergy and dermatology organizations, which recommends beginning with second-generation antihistamines and progressing to omalizumab and cyclosporine, with omalizumab receiving the highest recommendation based on robust evidence. A meta-analysis of 67 real-world studies found no cases of anaphylaxis in omalizumab-treated CSU patients, with common adverse effects limited to headache, nasopharyngitis, and arthralgia. The lecture continued to discuss newly approved FDA therapies such as dupilumab, shown effective in the Phase 3 LIBERTY-CUPID Study C. Lastly, the lecture covered new CSU investigational medications such as remibrutinib, a highly selective BTK inhibitor supported by the REMIX-1 and -2 trials, along with several other agents currently in clinical trials.