Allergic rhinitis (AR) is a prevalent condition that often originates in early childhood and continues into adulthood. Both environmental and genetic factors predispose children to develop AR. To manifest the clinical effects of AR, allergen-specific IgE activates mast cells upon exposure to environmental allergens and subsequently induces inflammation. However, since children have numerous non-allergic causes of rhinitis, a careful history, exposure assessment, and diagnostic testing are essential for proper diagnosis and management. Although the principles of allergen avoidance and pharmacotherapy are similar between adult and pediatric AR, disease-modifying interventions such as immunotherapy in children provide a unique opportunity to alter the natural history of AR and comorbid atopic conditions such as asthma.