Bilastine, a novel H1-antihistamine of the second generation, was only recently given the green light for the symptomatic treatment of allergic rhinitis (AR) and chronic urticaria (CU). Bilastine represents the development of studies on the effectiveness and safety of antihistamines. Multiple major controlled clinical studies have shown that AR therapy is effective in reducing nasal and ocular symptoms and improving quality of life for patients. Based on these findings, bilastine is a suitable medicine for the treatment of AR according to the latest EAACI/ARIA criteria. The literature study also shows that the 20 mg of bilastine given once day was beneficial in reducing symptoms and enhancing the quality of life for CU patients. Bilastine has a very safe and tolerable profile, almost identical to that of a placebo, with few negative effects on the central nervous system in particular. When higher-than-usual doses of antihistamines are required to manage symptoms, as is often the case in individuals with urticaria, the balance of effectiveness and safety offered by bilastine is especially useful.