Regional analgesia is much too important to be denied to patients on the basis of questionable allergic histories. Often, adverse reactions can be traced directly to the pharmacologic properties of the agents involved. The dentist must adequately distinguish these reactions from those directly related to allergic phenomena. For the comprehensive management of patients with allergic histories, the significance as well as the limitations of intracutaneous skin testing must be appreciated. The practitioner should recognize the need, make proper referrals, and interpret the results of skin tests appropriately. Hopefully, this report has served to disperse the confusion surrounding local anesthetic hypersensitivity and will enable more dentists to proceed with confidence in the assessment and management of their allergic patients.