ANAPHYLAXIS AND INSECT ALLERGY: Edited by Gianenrico Senna and Mariana CastellsEpinephrine in anaphylaxis: too little, too lateLieberman, Jay Adama; Wang, JuliebAuthor Information aDivision of Allergy & Immunology, Department of Pediatrics, University of Tennessee Health Science Center, LeBonheur Children's Hospital, Memphis, Tennessee bDivision of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York, USA Correspondence to Jay Adam Lieberman, MD, Division of Allergy/Immunology, Department of Pediatrics, 51N. Dunlap Street, Suite 400, Memphis, TN 38105, USA. Tel: +1 901 287 7337; e-mail: firstname.lastname@example.org Current Opinion in Allergy and Clinical Immunology: October 2020 - Volume 20 - Issue 5 - p 452-458 doi: 10.1097/ACI.0000000000000680 Buy Metrics Abstract Purpose of review Epinephrine is the agreed-upon first line treatment for anaphylaxis, yet it continues to be underused by patients/caregivers and providers alike. Recent findings There are unfortunately limited data on how epinephrine can best be utilized in anaphylaxis, which hinders how best to inform patients and providers. Studies reporting underuse suggest various barriers and themes on why this may happen. Summary Continued education of patients, caregivers, and providers is needed; however, is not likely to be enough to close the gap. Thus, novel studies on how to increase use; increase availability in a cost-effective manner; and newer, effective delivery routes are still needed. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.