Immunology underlies most of the biological and clinical disciplines in medicine. This includes autoimmune diseases, infectious diseases and HIV, primary immunodeficiency, cancer and transplantation medicine. Indeed, the formalised use of immunology knowledge, laboratory techniques and targeted immunotherapies in routine clinical practice is now commonplace in much of the world. It is the most rapidly advancing field, and generalists need to keep up with advances in knowledge that impact on patient management. This is the impetus behind this month's CME, entitled 'Updates in immunology and allergy' . The medical community, both clinical and pathology disciplines, can no longer afford to see immunology as a 'black box' discipline irrelevant to day-to-day patient management or only applicable to the uncommon case of immunodeficiency or autoimmune disease. For South African (SA) doctors this means considering immunology beyond HIV medicine. Is it time for immunology in SA, amid competing public health needs, to be established as a distinct specialty or sub-specialty? This issue of CME provides an overview and an update on clinical immunology that will be indispensable to all practitioners.