Background: Feline allergic skin disease presents a diagnostic challenge due to the potentially subtle and widely variable clinical presentations known as feline reaction patterns. Cats are often secretive in their pruritic behaviours and so, unlike with canine disease, the clinical history for a cat may not give insight into the presence of pruritus. Once a diagnosis of feline allergic disease is achieved, there are several treatment options available; however, the majority have not been studied extensively in cats and many represent off‐license use.Aim of the article: This article outlines the relevant steps in making a diagnosis of feline atopic skin syndrome and reviews the treatment options available.