Hay fever and allergic rhinitis are common conditions seen in primary care which can have a huge effect on the quality of life of sufferers The most important step in diagnosing hay fever or allergic rhinitis is to take an allergy focused clinical history. There are many treatment options available, including allergen avoidance, antihistamines and nasal corticosteroids. Many medications are now available over the counter; patients need to know how to take their medication correctly. Asthma frequently co-exists with allergic rhinitis and can make asthma symptoms much worse. General practice nurses (GPNs) are ideally placed to offer advice and support to these patients. If initial treatments fail, patients should return to primary care as there are a wide range of therapeutic interventions which may help. For those whose symptoms are very severe or not responding, immunotherapy may be an option, and the patient should be referred.