Summary: Chronic urticaria (chronic spontaneous urticaria, CSU) is a disease with a heterogeneous pathomechanism. The diagnosis and treatment of chronic urticaria is a great challenge for general practitioners, allergists and dermatologists due to the complex pathomechanism of the disease, the diverse manifestation of symptoms and the possibility of co-occurrence of two or more subtypes of urticaria in the patient. The first- and second-line treatment is second-generation antihistamines, and according to the EAACI / GA2LEN / EDF / WAO guidelines of 2019, the third-line treatment is omalizumab, a biological drug with proven effectiveness and safety of action. The National Health Fund program for the treatment of chronic spontaneous urticaria came into force on January 1, 2020. This is extremely important and provides opportunities for effective and safe treatment of patients with CSU in accordance with the recommendations of EAACI / GA2LEN / EDF / WAO.