The article summarizes up-to-date knowledge about effective diagnosis and treatment of anaphylactic reaction. It covers management of the acute anaphylactic reaction within the scope of emergency medicine, with special focus on the usage of intramuscularly injected adrenaline. Topics such as testing for allergies or the specific patophysiology of the anaphylaxis are not emphasized. The article is based on up-to-date guidelines and additional scientific evidence. Knowledge about the etiology and the risk factors is essential when diagnosing anaphylaxis. The diagnosis itself is based on the case circumstances, patients medical history and a physicians ability to assess the diverse signs of anaphylaxis. The ability to quickly diagnose, treat and immediately apply epinephrine is essential to halt the reaction in its beginning. A severe case of anaphylaxis can cause multiple serious organ dysfunctions resulting in refractory anaphylaxis and shock requiring organ support and specific medical measures. After the initial treatment, sequential procedures must be undertaken to minimalize the risk of a recurrent anaphylactic episode.