Purpose of review <p>Hymenoptera venom allergy is one of the most common causes of anaphylaxis. This review aims to provide an overview of venom allergy and to highlight the main differences to other anaphylaxis.</p> Recent findings <p>The predominant cardiovascular symptomatology, the milder expression in children and the higher risk of anaphylaxis after recurrent local large reactions are particularities of hymenoptera venom anaphylaxis (HVA). This risk is particularly high in beekeepers due to their high exposure to stings, making HVA an occupational disease. Other population groups, like patients with mastocytosis and/or hereditary alpha-tryptasemia are at higher risk of anaphylaxis regardless of the trigger. Diagnosis can be a challenge due to cross-reactivity of venoms. Skin tests are currently the <i>gold standard</i> since the provocation test is not indicated to perform unlike other triggers. HVA has specific treatment with venom immunotherapy, which is considered the most effective, whereas avoidance is not very feasible. To monitor its efficacy, sting challenge test practiced with live insects is the <i>gold standard</i>.</p> Summary <p>Anaphylaxis can be triggered by many allergens, mainly venoms, food and drugs. All of them have similarities, but there are identified points that make HVA different from food or drug-induced anaphylaxis. This review highlights these differences found.</p>