Summary: Cow’s milk protein allergy (CMPA) is one of the most common food allergies in infants and young children. The only effective management is the elimination of cow’s milk proteins from the child’s diet and, in breastfed infants, also from the mother’s diet. Although this approach effectively reduces clinical symptoms, it does not accelerate the development of tolerance. Moreover, overly restrictive or prolonged elimination diets may increase the risk of nutritional deficiencies and delay the weaning process. The contemporary approach to managing food allergy is shifting from passive elimination towards prevention and active modulation of the immune response. Key elements of CMPA prevention include supporting dietary diversity in both mother and child, breastfeeding, vaginal delivery, and early exposure to food allergens during the “window of tolerance”. Current methods used to modify the immune response include gradual reintroduction of cow’s milk proteins using the milk ladder (baked milk), early controlled exposure based on the ED05 (eliciting dose), oral immunotherapy, and biologic therapy with omalizumab, used either alone or in combination with immunotherapy. The aim of these interventions is to raise the reactivity threshold by supporting the development of tolerance and desensitization. However, evidence on their efficacy and safety remains limited, mainly due to the small number of heterogeneous studies involving highly selected patient populations and applying variable reintroduction protocols in terms of form, dose, and timing of cow’s milk protein introduction, as well as the lack of standardization and reproducibility for most of these methods. Selecting and implementing an appropriate strategy always requires an individualized assessment of risks and benefits for each patient.