Allergic reactions can rapidly evolve from seemingly minor symptoms into life-threatening airway compromise and distributive shock. This lecture explores the recognition and management of severe allergic reactions and anaphylaxis in the prehospital and emergency setting, emphasizing the importance of early identification and decisive intervention. Through case-based discussion and operational scenarios, participants will examine airway assessment, pharmacologic management, epinephrine administration, and resuscitation priorities in rapidly deteriorating patients. Special focus is placed on the pharmacology of commonly utilized medications such as epinephrine, antihistamines, corticosteroids, bronchodilators, and adjunctive therapies, with discussion centered on evidence-based practice, timing of intervention, and common misconceptions in allergic emergencies. Attendees will leave with practical strategies to recognize, treat, and stabilize critically ill allergy patients in both routine and resource-limited environments.