The pathogenic potential of Blastocystis spp. is extremely controversial. Recently, many researchers have discussed its inductive role in the etiology of various dermatological syndromes such as palmoplantar pruritus, acute, and chronic urticaria. The growing number of urticaria patients showing improvement after eradication of Blastocystis spp. infection, has proven its causative nature. Herein, we present a broad overview of the modern concept of the precise parasitological verification in the routine work-up of urticaria patients.