Food allergy is defined as an adverse immunologic reaction to allergens present in food and is associated with symptoms ranging from gastrointestinal discomfort to anaphylactic shock and death. The increase in prevalence and potential fatality of disease has led to increased efforts to find effective therapies and prophylaxis. While specific immunotherapy (SIT) is effective in desensitization against inhalant allergens, it is unadvised against food allergy because of the high risk of adverse side effects. A review of the recent literature shows that various approaches have been taken to develop safer and more effective SIT regimens. Here we discuss the use of recombinant allergens, peptides, DNA vaccines, immunostimulatory DNA sequences, and other bacterial products in SIT. In addition, we review nonspecific therapies such as anti-IgE administration and cytokine therapy as well as natural therapies such as probiotics and Chinese herbal medications. In conclusion, anti-IgE treatment and SIT using hypoallergenic recombinant allergens in combination with Th1-inducing adjuvants appear the most promising approaches. New initiatives to increase our understanding of the pathophysiology and immunologic mechanisms of food allergy along with the molecular characterization of food allergens should pave the way towards safer and more effective ways of combating this debilitating and potentially life-threatening disease.