Omalizumab is a recombinant humanized monoclonal antibody. Use of omalizumab is reported to benefit significantly patients with inadequately controlled moderate-to-severe persistent allergic asthma that is not controlled with high-dose inhaled corticosteroids. However, recent studies suggest that omalizumab might play an important role in the treatment of other potentially IgE mediated disease processes including: urticaria and angioedema, atopic dermatitis, allergic rhinitis, nasal polyposis and severe ocular allergies. Furthermore, addition of omalizumab to immunotherapy protocols is reported to be highly advantageous. Although omalizumab is generally well tolerated, reports on potential anaphylactic reactions as well as an association with Churg-Strauss syndrome necessitate close monitoring. The data reviewed are discussed with the aim of underlining unmet needs and making recommendations for future studies on omalizumab use. This might better guide future clinical practice regarding omalizumab treatment. This review article also discussed some patent related to the field.