Skin testing remains an essential diagnostic tool. in modern allergy practice. A significant variability has been reported regarding technical procedures, interpretation of results and documentation. This review has the aim of consolidating methodological recommendations through a critical analysis on past and recent data. This will allow a better understanding on skin prick test (SPT) history; technique; (contra-) indications; interpretation of results; diagnostic pitfalls; adverse reactions; and variability factors. (c) 2008 SEICAP. Published by Elsevier Espana, S.L. All rights reserved.